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Toto L, Viggiano P, Quarta A, Grassi M, De Nicola C, Aloia R, D'Aloisio R, Boscia G, Boscia F, Porreca A, Di Nicola M, Savastano MC, Mastropasqua R. Effect of Pro Re Nata regimen with anti-VEGF on Type 3 Macular Neovascularization - Long term outcomes. Ophthalmic Res 2024:000538441. [PMID: 38621369 DOI: 10.1159/000538441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/26/2024] [Indexed: 04/17/2024]
Abstract
(348 words) Introduction: The purpose of this study is to investigate long-term outcomes of intravitreal injections (IVI) of anti-vascular endothelial growth factor (VEGF) in neovascular age-related macular degeneration (nAMD) with type 3 macular neovascularization (MNV). METHODS This retrospective study included 19 eyes of 17 patients with nAMD and type 3 MNV treated with anti-VEGF IVI with a loading dose and PRN regimen. Best corrected visual acuity (BCVA), central macular thickness (CMT), presence of macular intraretinal fluid (IRF) and subretinal fluid (SRF), flow area (FA), subfoveal choroidal thickness (CT) and macular atrophy (MA) were assessed at baseline (T0) and during follow up (T1, post loading phase; T2, one year; T3, two years, T4>2 years). The correlations between MA at the last follow-up and standard deviation (SD) values of CMT and CT during follow-up were assessed. The influence of the number of injections on the change in MA over time was also analysed. MA differences at T4 were assessed for pseudodrusen presence. RESULTS BCVA improved significantly during follow-up (p=0.013) particularly increasing from baseline to post loading phase and then did not modify significantly thereafter. CMT significantly reduced from T0 to T1 and remained stable during follow-up (p = <0.001). MNV flow area showed a trend toward increase in the post loading phase that was not statistically significant (p=0.082) and CT decreased significantly during follow-up (p<0.001). MA changed significantly during follow-up (p<0.001) with significant increase from T0 to T3 and from T0 to T4 (p < 0.010). Cochrane Armitage test for trend showed a significant reduction (p=0.001) of macular IRF and SRF during follow-up. MA at T4 showed a significant positive correlation with SD (standard deviation) values of CMT (p=0.040) and CT (p=0.020). Indeed, the number of injections did not influence the change over time of MA (p=0.709). MA at T4 was not statistically significantly different between patients with pseudodrusen at baseline (p=0.497). CONCLUSIONS Intravitreal anti-VEGF injections with PRN regimen in MNV type 3 showed functional and anatomical benefits. Variations of retinal thickness and choroidal thickness during treatment were related to MA modification over time.
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Capone L, Airaghi P, Aragona P, Castellino N, Cicinelli MV, Ciucci F, Coppola M, Gaetano CD, Lattanzio R, Lorusso M, Maceroni M, Malvasi ME, Marco L, Marraffa M, Martini G, Mastropasqua R, Minnella AM, Nikolopulou E, Ortisi E, Pacella E, Papa V, Pennesi C, Reibaldi M, Rizzo S, Toto L, Trombetta L, Bandello F. Real-world experience with fluocinolone acetonide intravitreal implant in patients with diabetic macular edema. Eur J Ophthalmol 2024:11206721241235266. [PMID: 38396370 DOI: 10.1177/11206721241235266] [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: 02/25/2024]
Abstract
OBJECTIVES to evaluate long-term effectiveness and safety of fluocinolone acetonide (FAc) implant used as second-line treatment in patients with persistent diabetic macular edema (DME). METHODS retrospective data chart review of 241 pseudophakic eyes of 178 patients treated with FAc from July 2017 to December 2021 in 10 medical retinal units in Italy. The primary endpoint was the change of best-corrected visual acuity (BCVA) and central macular thickness (CMT) at 2 years. A Student's paired t-test was used. Additional therapies for DME and intraocular pressure (IOP)-related events were also evaluated. RESULTS efficacy of FAc was assessed in a subset of 111 eyes with at least 24 months of follow-up. Mean BCVA increased at 2 years by 5.1 ETDRS letters (95%CI = 2.6-7.5; p < 0.001) while mean CMT decreased by 189 µm (95% CI 151-227; p < 0.001). Thirty-eight of these eyes (34.2%) needed additional intravitreal treatments, mainly anti-VEGF. Safety was evaluated on the entire cohort of 241 eyes treated with FAc. Overall, 66 eyes (27.4%) required emergent IOP-lowering medications (typically within the first-year post FAc) while 14 eyes (5.8%) underwent trabeculectomy, mostly during the second year of follow-up. CONCLUSION FAc implant provides a substantial long-term functional and anatomical benefit when used as second-line treatment in eyes with DME. IOP rise can be adequately managed with topical agents although some eyes may require IOP-lowering surgery.
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Affiliation(s)
- Luigi Capone
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute-School of Medicine, Vita-Salute San Raffaele University Milan, Milano, Italy
| | - Pietro Airaghi
- Ophthalmology Unit, IRCCS S. Gerardo dei Tintori, Monza, Italy
| | - Pasquale Aragona
- Department of Biomedical Sciences, Ophthalmology Clinic, University of Messina, Messina, Italy
| | | | - Maria Vittoria Cicinelli
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute-School of Medicine, Vita-Salute San Raffaele University Milan, Milano, Italy
| | - Francesco Ciucci
- Ophthalmology Unit, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - Michele Coppola
- Ophthalmology Unit, IRCCS S. Gerardo dei Tintori, Monza, Italy
| | | | - Rosangela Lattanzio
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute-School of Medicine, Vita-Salute San Raffaele University Milan, Milano, Italy
| | - Massimo Lorusso
- Department of Ophthalmology, Ente Ecclesiastico F. Miulli Hospital, Bari, Italy
| | - Martina Maceroni
- Institute of Ophthalmology, Università Cattolica del Sacro Cuore-Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | | | | | - Michele Marraffa
- Department of Ophthalmology, ULSS 9 Scaligera, Orlandi Hospital, Bussolengo, Verona, Italy
| | - Gaia Martini
- Department of Ophthalmology, ULSS 9 Scaligera, Orlandi Hospital, Bussolengo, Verona, Italy
| | - Rodolfo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Angelo Maria Minnella
- Institute of Ophthalmology, Università Cattolica del Sacro Cuore-Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - Eleni Nikolopulou
- Department of Ophthalmology, Ente Ecclesiastico F. Miulli Hospital, Bari, Italy
| | - Elina Ortisi
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Elena Pacella
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | | | - Claudio Pennesi
- Ophthalmology Unit, IRCCS S. Gerardo dei Tintori, Monza, Italy
| | - Michele Reibaldi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy
| | - Stanislao Rizzo
- Institute of Ophthalmology, Università Cattolica del Sacro Cuore-Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Luigi Trombetta
- Department of Biomedical Sciences, Ophthalmology Clinic, University of Messina, Messina, Italy
| | - Francesco Bandello
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute-School of Medicine, Vita-Salute San Raffaele University Milan, Milano, Italy
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Quarta A, Gironi M, Ruggeri ML, Porreca A, D'Aloisio R, Toto L, Di Nicola M, Mastropasqua R. Analysis of Macular Pigment Optical Density in Macular Holes with Different Border Phenotypes. Ophthalmol Ther 2024; 13:571-580. [PMID: 38175467 PMCID: PMC10787731 DOI: 10.1007/s40123-023-00874-y] [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: 09/21/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION We conducted a cross-sectional study to compare macular pigment optical density (MPOD) in eyes with idiopathic macular holes with bumpy (bbMH) and smooth borders (sbMH) and to assess the relation between MPOD and optical coherence tomography findings. Thirty eyes from thirty patients affected by idiopathic macular hole were studied. METHODS All patients underwent SD-OCT and macular pigment optical density (MPOD) analysis. Comparison between the two border phenotypes were estimated at baseline, as well as the differences in MPOD, minimum and basal hole diameter, tractional hole index (THI), macular hole index (MHI), diameter hole index (DHI), and ELM integrity metrics between the two groups. RESULTS The mean MPOD was 0.09 ± 0.08 in bbMHs and 0.16 ± 0.11 in sbMHs (p = 0.010). Correlation analysis between MPOD and minimum hole diameter revealed a negative association (rho = - 0.707, p = 0.008) in bbMH and a positive association (rho = 0.702, p = 0.019) in sbMH. MPOD and basal diameter were negatively correlated in bbMH (rho = - 0.77, p = 0.001) and positively correlated in sbMH (rho = 0.675, p = 0.019). Indeed, MPOD is negatively correlated with THI and MHI in sbMH (rho = - 0.684 p = 0.019; rho = - 0.665 p = 0.019, respectively) and positively correlated in bbMH (rho = 0.593 p = 0.037; rho = 0.658 p = 0.018, respectively). CONCLUSIONS MPOD is significantly reduced in bbMHs compared to sbMHs. The two border phenotypes also differ for tractional and tangential indexes, possibly reflecting a different pathogenesis. Further studies are needed to understand the prognostic role of MPOD.
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Affiliation(s)
- Alberto Quarta
- Department of Sciences, Ophthalmology Clinic, National Center of High Technology in Ophthalmology, Gabriele D'Annunzio University, Via dei Vestini, 66100, Chieti, Italy.
| | - Matteo Gironi
- Department of Sciences, Ophthalmology Clinic, National Center of High Technology in Ophthalmology, Gabriele D'Annunzio University, Via dei Vestini, 66100, Chieti, Italy
| | - Maria Ludovica Ruggeri
- Department of Sciences, Ophthalmology Clinic, National Center of High Technology in Ophthalmology, Gabriele D'Annunzio University, Via dei Vestini, 66100, Chieti, Italy
| | - Annamaria Porreca
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, via dei Vestini 31, 66100, Chieti, Italy
| | - Rossella D'Aloisio
- Department of Sciences, Ophthalmology Clinic, National Center of High Technology in Ophthalmology, Gabriele D'Annunzio University, Via dei Vestini, 66100, Chieti, Italy
| | - Lisa Toto
- Department of Sciences, Ophthalmology Clinic, National Center of High Technology in Ophthalmology, Gabriele D'Annunzio University, Via dei Vestini, 66100, Chieti, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, via dei Vestini 31, 66100, Chieti, Italy
| | - Rodolfo Mastropasqua
- Department of Sciences, Ophthalmology Clinic, National Center of High Technology in Ophthalmology, Gabriele D'Annunzio University, Via dei Vestini, 66100, Chieti, Italy
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Quarta A, Gironi M, Ruggeri ML, Aharrh-Gnama A, Porreca A, D'Aloisio R, Toto L, Di Nicola M, Mastropasqua R. Baseline imaging characteristics and early structural changes in macula on rhegmatogenous retinal detachment. Sci Rep 2024; 14:1370. [PMID: 38228760 DOI: 10.1038/s41598-024-51183-8] [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: 04/28/2023] [Accepted: 01/01/2024] [Indexed: 01/18/2024] Open
Abstract
Animal models have demonstrated that structural changes affect the macula during peripheral rhegmatogenous retinal detachment. This study aimed to assess photoreceptors, retinal and choriocapillaris perfusion in non-macula involving rhegmatogenous retinal detachment by analyzing en-face images from structural OCTA segmented at the ellipsoid zone (EZ) level, calculating (1) "normalized" reflectivity as a surrogate biomarker of photoreceptor damage (2) perfusion density (PD), vessel length density (VLD) and vessel diameter index (VDI) of superficial capillary plexus (SCP) and deep capillary plexus (DCP) (3) perfusion density of choriocapillaris (PDCC). Twenty-one eyes affected by macula-on rhegmatogenous retinal detachment (RRD) were enrolled at the University "G. d'Annunzio", Chieti-Pescara. The fellow unaffected eye was used as control. The mean age at the onset of RRD was 60.09 ± 10.22 (range 34-83). Compared with fellow eyes, we found lower EZ "normalized" reflectivity in macula-on (0.42 ± 0.15 in fellow eyes and 0.31 ± 0.09 in macula on p = 0.004). The affected eye was also characterized by impaired perfusion in SCP (17.26 ± 3.34% in macula on and 20.56 ± 3.62% in the fellow eye p = 0.004) and CC (50.21 ± 6.20% in macula on the eye and 57.43 ± 6.20% in the fellow eye p = 0.004). Macula-on rhegmatogenous retinal detachment has subclinical changes in photoreceptors, SCP, and CC. Future longitudinal studies should evaluate if early changes could impact post-operative macular function.
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Affiliation(s)
- Alberto Quarta
- Department of Sciences, Ophthalmology Clinic, National Center of High Technology in Ophthalmology, Gabriele D'Annunzio University, Via dei Vestini, 66100, Chieti, Italy.
| | - Matteo Gironi
- Department of Sciences, Ophthalmology Clinic, National Center of High Technology in Ophthalmology, Gabriele D'Annunzio University, Via dei Vestini, 66100, Chieti, Italy
| | - Maria Ludovica Ruggeri
- Department of Sciences, Ophthalmology Clinic, National Center of High Technology in Ophthalmology, Gabriele D'Annunzio University, Via dei Vestini, 66100, Chieti, Italy
| | - Agbeanda Aharrh-Gnama
- Department of Sciences, Ophthalmology Clinic, National Center of High Technology in Ophthalmology, Gabriele D'Annunzio University, Via dei Vestini, 66100, Chieti, Italy
| | - Annamaria Porreca
- Department of Medical Oral Science and Biotechnology, G. d'Annunzio University of Chieti-Pescara Chieti, Via dei Vestini 31, Chieti, Italy
| | - Rossella D'Aloisio
- Department of Sciences, Ophthalmology Clinic, National Center of High Technology in Ophthalmology, Gabriele D'Annunzio University, Via dei Vestini, 66100, Chieti, Italy
| | - Lisa Toto
- Department of Sciences, Ophthalmology Clinic, National Center of High Technology in Ophthalmology, Gabriele D'Annunzio University, Via dei Vestini, 66100, Chieti, Italy
| | - Marta Di Nicola
- Department of Medical Oral Science and Biotechnology, G. d'Annunzio University of Chieti-Pescara Chieti, Via dei Vestini 31, Chieti, Italy
| | - Rodolfo Mastropasqua
- Department of Sciences, Ophthalmology Clinic, National Center of High Technology in Ophthalmology, Gabriele D'Annunzio University, Via dei Vestini, 66100, Chieti, Italy
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D'Aloisio R, Ruggeri ML, Porreca A, Di Nicola M, Aharrh-Gnama A, Quarta A, Gironi M, Toto L, Mastropasqua R. Choroidal Vascularity Index Fluctuations in Epiretinal Membranes in Vitreoretinal Surgery: Comparison Between Idiopathic and Diabetic Ones. Transl Vis Sci Technol 2023; 12:9. [PMID: 38060233 PMCID: PMC10709804 DOI: 10.1167/tvst.12.12.9] [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: 12/08/2023] Open
Abstract
Purpose The aim of the study was to analyze choroidal vascularity index (CVI) fluctuations in patients with epiretinal membrane after vitreoretinal surgery, comparing idiopathic and secondary diabetic ones. Methods Thirty eyes suffering from idiopathic ERMs (I-ERMS; n = 15) and diabetic ERMs (D-ERMS; n = 15) were analyzed in this observational prospective study. Anatomical (central macular thickness) and functional (best-corrected visual acuity) parameters were analyzed preoperatively and at 1 and 3 months after vitrectomy. Perfusion findings regarding CVI and luminal area were also calculated. Results At 1 month after surgery, the luminal area and CVI significantly decreased in the I-ERMS group, whereas they were increased in the D-ERMS group. At the 3-month follow-up, the CVI tended to return to baseline values in I-ERMS and to reduce in D-ERMS, but without any statistical differences. Conclusions The significant change in the CVI after surgery seems to imply that the choroidal layer is affected by vitreomacular disease and can become a novel potential biomarker of predictiveness in vitreoretinal surgery. Translational Relevance The aim of the study was to focus on the early choroidal changes to better understand initial predictive elements of long-term functional postoperative outcomes.
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Affiliation(s)
- Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti- Pescara, Chieti, Italy
| | - Maria Ludovica Ruggeri
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti- Pescara, Chieti, Italy
| | - Annamaria Porreca
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Agbéanda Aharrh-Gnama
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti- Pescara, Chieti, Italy
| | - Alberto Quarta
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti- Pescara, Chieti, Italy
| | - Matteo Gironi
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti- Pescara, Chieti, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti- Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti- Pescara, Chieti, Italy
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Viggiano P, Boscia G, Borrelli E, Toto L, Grassi MO, Evangelista F, Giancipoli E, Alessio G, Boscia F. Choriocapillaris Reperfusion in Resolved Chronic Central Serous Chorioretinopathy Treated with Eplerenone: Long-Term Effects on the Fellow Eye. Ophthalmol Ther 2023; 12:3199-3210. [PMID: 37747638 PMCID: PMC10640459 DOI: 10.1007/s40123-023-00816-8] [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: 08/05/2023] [Accepted: 09/06/2023] [Indexed: 09/26/2023] Open
Abstract
INTRODUCTION The aim of this work is to utilize swept-source optical coherence tomography angiography (SS-OCTA) to assess the long-term changes in the choroidal and choriocapillaris (CC) layers of the fellow unaffected eye of patients with unilateral resolved chronic central serous chorioretinopathy (cCSC) following treatment with continuous oral eplerenone (EPL). METHODS The study included 35 patients with cCSC and subretinal fluid (SRF) in one eye. SS-OCTA imaging was performed on the fellow cCSC eyes at baseline, 6 months, and 12 months during eplerenone therapy. CC OCT angiography was analyzed to determine the percentage of choriocapillaris flow deficits (FD%), the number of flow deficits (FDn), and the average area of flow deficits (FDa). RESULTS The results demonstrated significant changes in CC flow deficits from baseline to follow-up visits. Specifically, there was a significant decrease in FD% from 28.9 ± 2.2% at baseline to 26.4 ± 1.9% at 6 months (p = 0.023), and further to 24.9 ± 1.7% at 12 months (p = 0.001). Additionally, the FD area gradually contracted over the follow-up period (p < 0.05). Conversely, there was a significant increase in the number of flow deficits compared to baseline (p < 0.05). No statistically significant changes were observed in best-corrected visual acuity (BCVA) at the follow-up visits (p > 0.05). CONCLUSIONS The findings of this study demonstrated long-term reperfusion of the choriocapillaris in unaffected fellow cCSC eyes during continuous oral eplerenone therapy. The beneficial effects of eplerenone therapy were observed after 6 months and maintained at 1 year. These results suggest that specific mineralocorticoid receptor (MR) antagonists may be effective in promoting choriocapillaris recovery in the unaffected eyes of patients with cCSC.
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Affiliation(s)
- Pasquale Viggiano
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, Bari, Italy.
| | - Giacomo Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, Bari, Italy
| | - Enrico Borrelli
- Ophthalmology Department, San Raffaele University Hospital, Milan, Italy
| | - Lisa Toto
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Maria Oliva Grassi
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, Bari, Italy
| | - Federica Evangelista
- Department of Ophthalmology, Ente Ecclesiastico Ospedale Generale Regionale "F. Miulli", Acquaviva Delle Fonti, Bari, Italy
| | | | - Giovanni Alessio
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, Bari, Italy
| | - Francesco Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, Bari, Italy
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Ruggeri ML, Toto L, D'Aloisio R, Quarta A, Aloia R, Venturoni P, De Nicola C, Doronzo E, Gironi M, Porreca A, Di Nicola M, Mastropasqua R. Long-Term Follow-Up of Brolucizumab in Macular Neovascularization. Ophthalmic Res 2023; 66:1383-1391. [PMID: 38029730 DOI: 10.1159/000534894] [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: 08/13/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION The aim of the study was to evaluate functional and anatomical changes in type 1 and type 2 naïve macular neovascularization (MNV) patients treated with brolucizumab injections up to 1 year of treatment (week 48). METHODS Thirty-eight eyes of 38 patients with active MNV were enrolled at the Ophthalmology Clinic of the University "G. d'Annunzio," Chieti-Pescara, Italy. All patients were scheduled for brolucizumab intravitreal injections as per label, according to the standard HAWK and HARRIER trials guidelines. Enrolled patients underwent complete ophthalmic evaluation, including optical coherence tomography (OCT) and OCT angiography. All measurements were evaluated at baseline and then monthly up to week 48. The main outcome measures were changes in best-corrected visual acuity (BCVA); central macular thickness (CMT); subfoveal choroidal thickness (SCT); pigment epithelial detachment presence and maximum height (PEDMH); intraretinal fluid (IRF) presence, subfoveal subretinal fluid (SSRF) presence and maximum height, macular atrophy area, and neovascular membrane flow area in the slab extending from the outer retina to choriocapillaris (ORCC flow). RESULTS CMT and BCVA significantly changed in both groups over time. ORCC flow and SCT significantly reduced in both groups over time. Atrophy areas increased from 0 to 0.17 mm2 and from 0 to 0.23 mm2 in type 1 MNV and type 2 MNV patients, respectively. PEDMH reduced in type 1 MNV from 138 μm at T0 to 96 μm at T5. Changes in fluids were noted, with SSRF thickness reduction and IRF changes in both groups. CONCLUSION Our one-year results of treatment confirm brolucizumab to be efficient and safe in both type 1 and type 2 MNV patients, proposing novel OCT parameters as possible biomarkers of treatment.
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Affiliation(s)
- Maria Ludovica Ruggeri
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Alberto Quarta
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Raffaella Aloia
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Patrizio Venturoni
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Chiara De Nicola
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Emanuele Doronzo
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Matteo Gironi
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Annamaria Porreca
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Department of Neurosciences, Imaging and Clinical Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
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Mastropasqua L, Pedrotti E, Ruggeri ML, Vecchiarino L, Bonacci E, Guarini D, Falconio G, Toto L, Marchini G. Two-surgeon, two-center evaluation of a new combined EDOF intraocular lens approach. J Cataract Refract Surg 2023; 49:512-517. [PMID: 36700935 DOI: 10.1097/j.jcrs.0000000000001145] [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: 05/04/2022] [Accepted: 01/12/2023] [Indexed: 01/27/2023]
Abstract
PURPOSE To evaluate visual performance and quality of life after bilateral implantation of 2 extended depth-of-focus intraocular lenses (EDOF IOLs). SETTING Ophthalmology Clinic, Department of Medicine and Science of Ageing, University "G. d'Annunzio" Chieti-Pescara, Italy, and Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy. DESIGN Prospective clinical study. METHODS 60 eyes of 30 patients with senile cataract were enrolled in this study. Patients underwent phacoemulsification and bilateral implantation of the Mini WELL IOL in the dominant eye and the Mini WELL PROXA IOL in the nondominant eye within a month. The main outcome measures over a 3-month follow-up period were uncorrected and corrected visual acuity at different distances (33 cm, 60 cm, and 4 m), defocus curve, contrast sensitivity, and patient satisfaction (evaluated by mean of the National Eye Institute Refractive Error Quality-of-Life instrument-42 questionnaire). RESULTS Binocular uncorrected visual acuity at 90 days was 0.03 ± 0.11 logMAR for long distance, 0.05 ± 0.10 logMAR for intermediate distance, 0.03 ± 0.08 logMAR at 40 cm, and 0.06 ± 0.08 logMAR at 33 cm. Statistically significant differences between the 2 EDOF IOLs in favor of Mini WELL PROXA IOL were observed for uncorrected near visual acuity at 40 and 33 cm ( P < .001 and P < .001, respectively) and for distance-corrected near visual acuity at 40 cm ( P < .001). Significant differences between the 2 IOLs in the defocus curves were reported. CONCLUSIONS In this small pilot study, bilateral implantation of Mini WELL IOL and Mini WELL PROXA IOL achieved good quantity and quality of vision.
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Affiliation(s)
- Leonardo Mastropasqua
- From the Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy (Mastropasqua, Ruggeri, Vecchiarino, Guarini, Falconio, Toto); Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy (Pedrotti, Bonacci, Marchini)
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9
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Toto L, Ruggeri ML, Evangelista F, Viggiano P, D'Aloisio R, De Nicola C, Falconio G, Di Nicola M, Porreca A, Mastropasqua R. Choroidal modifications assessed by means of choroidal vascularity index after oral eplerenone treatment in chronic central serous chorioretinopathy. Eye (Lond) 2023; 37:1214-1218. [PMID: 35590104 PMCID: PMC10101961 DOI: 10.1038/s41433-022-02091-6] [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: 09/01/2021] [Revised: 04/07/2022] [Accepted: 05/05/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To investigate choroidal vascularity index (CVI) changes after oral eplerenone treatment in chronic central serous chorioretinopathy (cCSC) using the Spectral-domain (SD)-Optical Coherence Tomography (OCT) with enhanced depth imaging (EDI) mode. METHODS Thirty-six eyes of 18 patients suffering from cCSC with monolateral foveal subretinal fluid (FSRF) successfully treated with oral eplerenone treatment and 18 age-matched healthy subjects were enroled in this retrospective study. EDI-OCT images obtained using Heidelberg Spectralis OCT device in patients with cCSC and FSRF (group 1); fellow eye (group 2) or healthy patients (healthy) were exported and then imported into image analysis ImageJ software for subsequent quantitative analysis. The main outcome measures were luminal area (LA) and CVI. RESULTS A higher value of CVI was detected in group 1 compared to healthy eyes (p = 0.006). LA and CVI significantly reduced during follow up in group 1 and group 2. LA at 120 days was significantly lower compared to all previous time points both in group 1 and group 2 (p < 0.001). Median and [1st -3rd quartile] CVI values were 0.8 [0.7; 1.1] at baseline, 0.8 [0.7; 0.9] at 30 days; 0.7 [0.6; 0.9] at 60 and 90 days and 0.6 [0.5; 0.8] at 120 days in group 1 (p = 0.007) and 0.7 [0.6; 0.9] at baseline, 0.7 [0.7; 0.8] at 30 days; 0.7 [0.6; 0.7] at 60 and 90 days and 0.6 [0.6; 0.7] at 120 days in group 2 (p = 0.018). CONCLUSIONS Choroidal vascularity index reduced in cCSC patients after oral eplerenone treatment during follow up both in eyes with SRF and fellow eyes thus demonstrating the effectiveness of mineral corticoid receptor antagonists in recovering choroidal morphology.
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Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Maria Ludovica Ruggeri
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | | | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
| | - Chiara De Nicola
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Gennaro Falconio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Annamaria Porreca
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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Gironi M, D’Aloisio R, Verdina T, Shkurko B, Toto L, Mastropasqua R. Bilateral Branch Retinal Vein Occlusion after mRNA-SARS-CoV-2 Booster Dose Vaccination. J Clin Med 2023; 12:jcm12041325. [PMID: 36835860 PMCID: PMC9967668 DOI: 10.3390/jcm12041325] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/29/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
PURPOSE We report a case of a patient with a bilateral branch retinal vein occlusion (BRVO) 24 h after a booster vaccination with the mRNA-1237 vaccine. OBSERVATIONS Fluorescein angiography, performed at three weeks follow-up, showed vascular leakage and blockage, corresponding to hemorrhage areas associated with ischemic areas in the macula and along the arcades involved in the occlusion. CONCLUSIONS The patient was scheduled for urgent injections of intravitreal ranibizumab and laser photocoagulation of the ischemic areas. To the best of our knowledge, this is the first case described of concomitant bilateral RVO after COVID-19 vaccination. The rapid onset of the side effects in a patient with multiple risk factors for thrombotic events suggests that vulnerable microvascular conditions require detailed investigations before administration of a COVID-19 vaccine.
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Affiliation(s)
- Matteo Gironi
- Ophthalmology Clinic, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, 41125 Policlinico, Italy
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy
| | - Rossella D’Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy
- Correspondence:
| | - Tommaso Verdina
- Ophthalmology Clinic, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, 41125 Policlinico, Italy
| | - Benjamin Shkurko
- Ophthalmology Clinic, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy
| | - Rodolfo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy
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Toto L, Ruggeri ML, D'Aloisio R, De Nicola C, Trivigno C, Cerino L, Di Marzio G, Di Nicola M, Porreca A, Mastropasqua R. Brolucizumab Intravitreal Injection in Macular Neovascularization Type 1: VA, SD-OCT, and OCTA Parameter Changes during a 16-Week Follow-Up. Ophthalmic Res 2022; 66:218-227. [PMID: 36162382 DOI: 10.1159/000526851] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/31/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study was to assess early anatomical and functional changes after brolucizumab intravitreal injection (BIVI) in patients with age-related macular degeneration (AMD) and macular neovascularization type 1 (MNV1). METHODS A total of 24 eyes of 24 patients suffering from naïve AMD with MNV1 candidates to BIVI as per label with q12/q8 dosing regimen after the loading dose were enrolled in this prospective study. Main outcome measures during a 16-week follow-up period included changes in best corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal subretinal fluid (SSRF) thickness (SSRFT), subfoveal sub-retinal pigment epithelium (RPE) fluid thickness (SSRPEFT), subfoveal choroidal thickness (SFCT), and pigment epithelial detachment (PED) maximum height (PED-MH). In addition, MNV1 flow area; percentages of eyes with intraretinal fluid (IRF), subretinal fluid, and sub-RPE fluid at different time points; and percentages of eyes candidates to a q8 or q12 injection interval after disease activity assessment at week 16 were evaluated. RESULTS BCVA improved significantly from baseline (T0) to week 12 (T3) (p = 0.028). CMT showed a significant reduction from 456 ± 123 µm at T0 to 265 ± 85 µm at T3 (p < 0.001). SSRFT and SSRPEFT reduced significantly as well (p < 0.001 and p = 0.049, respectively). PED-MH and SFCT reduced significantly at the different time points (p = 0.020; p = 0.006, respectively). IRF presence changed significantly from 41.7% of eyes at T0 to 20.8% at T3 (p = 0.045). SSRF reduced significantly during follow-up, being present in 62.5% of eyes at T0 and 4.2% of eyes at T3 (p < 0.001). Subfoveal sub-RPE fluid decreased significantly during time, being present in 20.8% of eyes at T0 and 0% at T3 (p = 0.013). Most of the eyes (18 eyes, 75%) at week 16 after disease activity assessment were shifted in the q12 interval, and only a minority of eyes shifted in a q8 interval (6 eyes, 25%). CONCLUSION Brolucizumab is efficient in AMD patients with MNV1 by reducing all retinal fluids during the loading phase and shows reduction of macular thickness, choroidal thickness, and PED height. Most eyes at disease activity assessment (75%) fall into 12-week interval and the minority (25%) into the 8-week interval.
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Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Maria Ludovica Ruggeri
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Chiara De Nicola
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Chiara Trivigno
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Luca Cerino
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Guido Di Marzio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. D'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Annamaria Porreca
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. D'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Ophthalmology Clinic, Department of Neurosciences, Imaging and Clinical Science, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
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Toto L, D’Aloisio R, Quarta A, Libertini D, D’Onofrio G, De Nicola C, Romano A, Mastropasqua R. Intravitreal Dexamethasone Implant (IDI) Alone and Combined with Navigated 577 nm Subthreshold Micropulse Laser (SML) for Diabetic Macular Oedema. J Clin Med 2022; 11:jcm11175200. [PMID: 36079129 PMCID: PMC9457485 DOI: 10.3390/jcm11175200] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/27/2022] [Accepted: 08/29/2022] [Indexed: 11/23/2022] Open
Abstract
Background: The anatomical and functional changes after intravitreal dexamethasone implant (IDI) alone and combined with navigated subthreshold micropulse laser (NSML) in diabetic macular oedema (DMO) were compared. Methods: Patients with a clinically confirmed diagnosis of non-proliferative diabetic retinopathy (NPDR) and DMO were enrolled in this prospective study and were randomly assigned to two different treatment groups: thirty patients were treated with IDI (IDI group), and the other 30 patients received IDI combined with NSML treatment (combined IDI/NSML group). All patients during a 6-month follow-up underwent best corrected visual acuity (BCVA) evaluation and spectral domain optical coherence tomography (SD OCT). The main outcome measures were: BCVA, central macular thickness (CMT); (3) choroidal vascularity index (CVI), subfoveal choroidal thickness (SCHT); and time to retreatment between IDI at baseline and the second implant in both groups. Results: BCVA, CMT, and SCHT significantly decreased starting from the 1-month follow-up and CVI from 3 months in both groups. The between-group differences were significantly different from 1-month follow-up for BCVA, from 5-month follow-up for CMT and SCHT, and from 4-month follow-up for CVI. The Needed to Treat analysis indicated that six patients would have to be treated with SML after IDI in order for just one person to receive a benefit. Conclusions: the combined treatment showed good anatomical and functional outcomes for the treatment of DMO. In addition, IDI/SML seems to reduce injection frequency over time, improving patients’ quality of life and reducing the socio-economic burden.
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D’Aloisio R, Di Antonio L, Toto L, Rispoli M, Di Iorio A, Delvecchio G, Mastropasqua R. Choroidal Changes in Blood Flow in Patients with Intermediate AMD after Oral Dietary Supplement Based on Astaxanthin, Bromelain, Vitamin D3, Folic Acid, Lutein, and Antioxidants. Medicina (Kaunas) 2022; 58:medicina58081092. [PMID: 36013559 PMCID: PMC9412262 DOI: 10.3390/medicina58081092] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/04/2022] [Accepted: 08/09/2022] [Indexed: 11/18/2022]
Abstract
Background and Objectives: The aim of this study was to investigate the impact of oral administration of the combination of astaxanthin (AXT), lutein, folic acid, vitamin D3, and bromelain with antioxidants on choroidal blood flow in patients with age-related intermediate macular degeneration (AMD). Materials and Methods: Patients affected by intermediate AMD and treated with daily oral nutritional supplement with AXT, bromelain, vitamin D3, folic acid, lutein, and antioxidants for a period of at least 6 months were included in this retrospective study. A control group homogenous for age and sex was also included in the analysis. All participants underwent a complete ophthalmologic examination, spectral domain optical coherence tomography (SD-OCT), and optical coherence tomography angiography (OCTA) evaluation. Outcome measures were choroidal thickness (CHT) and choriocapillary vessel density (CCVD) after six months of AXT assumption. Results: CCVD values showed statistically significant difference between cases and controls at baseline (p < 0.001) and in the cases during follow-up (p < 0.001). The CHT measurements showed statistically significant difference between cases and controls (p = 0.002) and in the cases during follow-up (p < 0.001). Conclusions: The combined use of structural OCT and OCTA allows for a detailed analysis in vivo of perfusion parameters of the choriocapillaris and choroid and evaluation of changes of choroidal blood flow after oral nutritional supplements that affect blood flow velocity.
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Affiliation(s)
- Rossella D’Aloisio
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, Chieti-Pescara, 66100 Chieti, Italy
- Correspondence:
| | - Luca Di Antonio
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, Chieti-Pescara, 66100 Chieti, Italy
| | - Lisa Toto
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, Chieti-Pescara, 66100 Chieti, Italy
| | - Marco Rispoli
- Ophthalmology Department UOSD Medical Retina, Eye Hospital, 00193 Rome, Italy
| | - Angelo Di Iorio
- Department of Innovative Technologies in Medicine & Dentistry, University “G. d’Annunzio”; Chieti-Pescara, 66100 Chieti, Italy
| | - Giancarlo Delvecchio
- Department of Ophthalmology, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Rodolfo Mastropasqua
- Department of Ophthalmology, University of Modena and Reggio Emilia, 41121 Modena, Italy
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14
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D’Aloisio R, Gironi M, Verdina T, Vivarelli C, Leonelli R, Mariotti C, Kaleci S, Toto L, Mastropasqua R. Early Structural and Vascular Changes after Within-24 Hours Vitrectomy for Recent Onset Rhegmatogenous Retinal Detachment Treatment: A Pilot Study Comparing Bisected Macula and Not Bisected Macula. J Clin Med 2022; 11:jcm11123498. [PMID: 35743566 PMCID: PMC9225027 DOI: 10.3390/jcm11123498] [Citation(s) in RCA: 2] [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: 04/25/2022] [Revised: 06/03/2022] [Accepted: 06/11/2022] [Indexed: 01/27/2023] Open
Abstract
Background: In this study we aimed at investigating macular perfusion/anatomical changes in eyes with early onset rhegmatogenous retinal detachment (RRD) after prompt surgery within 24 hours, comparing a bisected macula and not bisected macula RRD. Methods: In this prospective observational study, 14 eyes of 14 patients who underwent within-24 hours vitreoretinal surgery for early onset RRD were enrolled. Patients were further divided into two subgroups: the not bisected macula group (NBM group) and the bisected macula group (BM group). At baseline and 3-month follow up, macular architecture and vessel analysis were assessed using optical coherence tomography angiography (OCTA) imaging. In detail, quantitative and qualitative analyses of the macular area were performed to quantify topographical retinal perfusion changes after surgery, calculating the foveal avascular zone (FAZ), vessel density (VD) and vessel length density (VLD) at the superficial capillary plexus (SCP) and deep capillary plexus (DCP). Results: Most cases (43%) were superotemporal RRD. Primary retinal reattachment was obtained in all cases, without recurrences within 3-month follow up. After surgery, a significant FAZ enlargement was observed at both the SCP and DCP level (p < 0.001; p < 0.05), with a significant effect of time noted between the two time points in the NBM and BM subanalysis (F = 3.68; p < 0.017). An excellent functional outcome was maintained for the whole follow-up. On the other hand, after surgery, perfusion parameters did not change significantly apart from the vessel density of the inferior macular sector at the DCP level (p = 0.03). Conclusions: Our findings suggest that the macular perfusion of eyes with RRD is still preserved if the surgery is performed really promptly, thus highlighting the great importance of a correct timing for surgery. OCTA analysis allows for a better understanding of the pathophysiological mechanisms underneath early vascular microarchitecture modifications of the posterior pole in retinal detachment, differentiating the two types of RRD not completely involving the fovea (BM and NBM).
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Affiliation(s)
- Rossella D’Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University Gabriele D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.T.); (R.M.)
- Correspondence:
| | - Matteo Gironi
- Ophthalmology Clinic, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, 41122 Modena, Italy; (M.G.); (T.V.); (C.V.); (R.L.)
| | - Tommaso Verdina
- Ophthalmology Clinic, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, 41122 Modena, Italy; (M.G.); (T.V.); (C.V.); (R.L.)
| | - Chiara Vivarelli
- Ophthalmology Clinic, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, 41122 Modena, Italy; (M.G.); (T.V.); (C.V.); (R.L.)
| | - Riccardo Leonelli
- Ophthalmology Clinic, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, 41122 Modena, Italy; (M.G.); (T.V.); (C.V.); (R.L.)
| | - Cesare Mariotti
- Eye Clinic, AOU Ospedali Riuniti Ancona-Polytechnic University of Marche, 60121 Ancona, Italy;
| | - Shaniko Kaleci
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest Transplant, Oncological and Regenerative Medicine, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, 41122 Modena, Italy;
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University Gabriele D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.T.); (R.M.)
| | - Rodolfo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University Gabriele D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.T.); (R.M.)
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Parravano M, Eandi CM, Figus M, Lupidi M, Menchini F, Nicolo' M, Parisi V, Toto L, Viola F, Vujosevic S, Querques G. Effects of circadian rhythm disruption on retinal physiopathology: Considerations from a consensus of experts. Eur J Ophthalmol 2022; 32:2489-2493. [PMID: 35656746 PMCID: PMC9373193 DOI: 10.1177/11206721221106149] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The circadian rhythms originate within the organism and synchronize with cyclic
fluctuations in the external environment. It has been demonstrated that part of the human
genome is under control of the circadian clock and that a synchronizer that helps to
maintain daily rhythms is Melatonin, a neuro-hormone primarily synthesized by the pineal
gland during the night. The chronic disruption of circadian rhythm has been linked to many
conditions such as obesity, metabolic syndrome, type 2 diabetes, cancer, and
neurodegenerative diseases. Studies in the mice showed that the disruption of the retinal
circadian rhythm increases the decline during the aging of photoreceptors, accelerating
age-related disruption of cone cell structure, function, and viability and that the
melatonin receptor deletion seems to influence the health of retinal cells, speeding up
their aging. In conclusion, preserving the circadian rhythms could be to add to the
prevention and treatment of age-related degenerative retinal diseases, and although
additional studies are needed, melatonin could be a valid support to favor this
“chronoprotection action”.
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Affiliation(s)
| | - C M Eandi
- Department of Surgical Sciences, University of Torino, Torino, Italy.,Fondation Asile des Aveugles, Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland.,Macula Onlus Foundation, Genoa, Italy
| | - M Figus
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, 9310University of Pisa, Pisa, Italy
| | - M Lupidi
- Macula Onlus Foundation, Genoa, Italy.,Eye Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - F Menchini
- Department of Medicine-Ophthalmology, University of Udine, Udine, Italy
| | - M Nicolo'
- Macula Onlus Foundation, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), 9302University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, University Eye Clinic of Genoa, Genoa, Italy
| | - V Parisi
- 61870IRCCS-Fondazione Bietti, Rome, Italy
| | - L Toto
- Ophthalmic Clinic, Department of Medicine and Science of Ageing, University "G. 9301d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - F Viola
- Foundation IRCCS Cà Grande Ospedale Maggiore Policlinico, 9304University of Milan, Milan, Italy
| | - S Vujosevic
- Department of Biomedical, Surgical and Dental Sciences University of Milan, Milan, Italy.,Eye Clinic, IRCCS MultiMedica, Milan, Italy
| | - G Querques
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute, Milan, Italy
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Toto L, D'Aloisio R, Libertini D, D'Onofrio G, De Nicola C, Mastropasqua R, Chiarelli AM. Study of Nonperfusion Area Changes after Ranibizumab Intravitreal Injection for Diabetic Macular Edema by Means of Widefield OCT Angiography. Ophthalmic Res 2022; 66:8-13. [PMID: 35313317 DOI: 10.1159/000523749] [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: 01/01/2022] [Accepted: 02/12/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate changes in retinal capillary nonperfusion areas (RCNPA) and the retinal capillary vessel density (RCVD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) using widefield optical coherence tomography angiography (WFOCTA) in patients with diabetic retinopathy (DR) and diabetic macular edema (DME) treated with intravitreal ranibizumab injection (IRI). MATERIALS AND METHODS Twenty-four eyes of 24 patients with DR and DME candidates to a loading dose of IRI were enrolled. All patients underwent WFOCTA with the PLEX Elite 9000 device with 15 × 9 mm scans centered on the foveal center at baseline (T0) and 1 month after each intravitreal injection at 30 days (T1), 60 days (T2), and 90 days (T3). In all patients, the variation of RCNPA and the RCVD of the SCP and DCP were calculated using automatic software written in MATLAB (MathWorks, Natick, MA, USA). RESULTS The SCP showed a significant longitudinal variation of RCNPA (p = 0.04). Post hoc analysis revealed a statistically significant reduction of RCNPA at T1 (p = 0.04) and a nonsignificant reduction at T2 (p = 0.18) and T3 (p = 0.96). The DCP showed longitudinal changes in the RCNPA that tended to statistical significance (p = 0.09). Post hoc analysis revealed a trend toward a statistically significant reduction of RCNPA at T3 (p = 0.09) not statistically significant at T1 (p = 0.17) and T2 (p = 0.75). The RCVD of SCP and DCP showed no significant changes at any of the time points. CONCLUSIONS WFOCTA showed a decrease in RCNPA after IRI, probably related to the reperfusion of retinal capillaries.
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Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Daniele Libertini
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Giada D'Onofrio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Chiara De Nicola
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
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Toto L, D'Aloisio R, De Nicola C, Evangelista F, Ruggeri ML, Cerino L, Simonelli MB, Aharrh-Gnama A, Di Nicola M, Porreca A, Mastropasqua R. Short-term comparison between navigated subthreshold microsecond pulse laser and oral eplerenone for chronic central serous chorioretinopathy. Sci Rep 2022; 12:4727. [PMID: 35304566 PMCID: PMC8933552 DOI: 10.1038/s41598-022-08764-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 10/13/2021] [Accepted: 03/10/2022] [Indexed: 11/23/2022] Open
Abstract
To compare the anatomical/functional changes after navigated subthreshold pulse laser (SML) and oral eplerenone therapy for chronic central serous chorioretinopathy (cCSC). A total of 36 eyes of 36 patients suffering from cCSC treated with navigated SML (Navilas® 577s; OD-OS GmbH, near Berlin, Germany) (18 eyes, SML group) and oral eplerenone (18 eyes, eplerenone group) were enrolled in this retrospective study. Main outcome measures during a 3-month follow up period included changes of best corrected visual acuity (BCVA), central macular thickness (CMT), foveal subretinal fluid thickness (FSRFT), and subfoveal choroidal thickness (SFCT). At baseline average duration of symptoms was 6.8 ± 0.6 months in SML group and 6.4 ± 0.9 months in eplerenone group (p = 0.127). Mean BCVA, CMT and FSRFT changed significantly over time (p < 0.001). From baseline to 90 days the BCVA improved from 0.3 ± 0.1 to 0.1 ± 0.1 logMAR in SML group and from 0.3 ± 0. to 0.2 ± 0.1 logMAR in eplerenone group, CMT reduced from 357.1 ± 104.3 to 210.6 ± 46.7 μm and from 428.7 ± 107.7 to 332.5 ± 27.5 μm in SML group and eplerenone group respectively, FSRFT reduced from 144.4 ± 108.2 to 22.6 ± 37.2 μm and from 217.1 ± 105.9 to 54.4 ± 86.2 μm in SML group and eplerenone group. 55.6% of patients in SML group and 66.7% in eplerenone group showed a complete resolution of FSRFT during follow up. The interaction between group and time was statistically significant with greater absolute variation for CMT and FSRFT in SML group compared to eplerenone group (p < 0.001 and p = 0.043). SFCT did not change significantly during follow up (p = 0.083) for both groups. Both navigated SML and oral eplerenone were effective treatments showing recovery of retinal morphology and related visual acuity improvement in cCSC.
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Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy.
| | - Chiara De Nicola
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Maria Ludovica Ruggeri
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Luca Cerino
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Maria Beatrice Simonelli
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Agbéanda Aharrh-Gnama
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Annamaria Porreca
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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Neri G, Toto L. Is there a gold standard to assess haemodynamic retina perfusion? Acta Otorhinolaryngol Ital 2021; 41:574-575. [PMID: 34825671 PMCID: PMC8686803 DOI: 10.14639/0392-100x-n1735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 06/21/2021] [Indexed: 11/29/2022]
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Appolloni R, Viggiano P, Carrella ML, Evangelista F, Appolloni A, Toto L, Mastropasqua L. Femto-assisted versus conventional phacoemulsification differently impact on choroid structure after surgery. Eur J Ophthalmol 2021; 32:2194-2200. [PMID: 34585600 DOI: 10.1177/11206721211048360] [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: 11/17/2022]
Abstract
PURPOSE To report potential choroidal changes in eyes undergoing femtosecond laser cataract surgery (FLACS) and phacoemulsification surgery (PCS) by OCT. METHODS The patients were images by means Spectral Domain OCT imaging with EDI technology which may obtain OCT image. We exported a single EDI-OCT scan passing through the fovea and then it was imported into ImageJ program to perform a quantitative analysis. MAIN OUTCOME MEASURES The main outcome measures were: (i) sub foveal choroidal thickness (SFCT); (ii) the choroidal vascularity index (CVI); and (iii) central retinal thickness (CRT). RESULTS At postoperative 1 week, FLACS group showed an increased CRT (241.2 ± 31.6-245.5 ± 36.4 µm; p = 0.016). Likewise, CVI and SFCT exhibited a slight increase but no statistically differences were highlighted (p > 0.05). At the follow-up visit of 1 month, all OCT parameters did not display any significant difference (p > 0.05). At post-operative 1 week, the PCS group displayed a significant increase in CRT, SFCT, and CVI. On the contrary, at the follow-up visit of 1-month, all choroidal parameters were characterized by a no statistically significant reduction (p > 0.05). CONCLUSIONS Our study exhibited a significant increase in CT and CVI in eyes that underwent conventional cataract surgery. Femtosecond laser-assisted cataract extraction did not result in macular change due to less postoperative inflammation.
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Affiliation(s)
| | | | | | | | | | - Lisa Toto
- Gabriele d'Annunzio University of Chieti-Pescara, Chieti, Italy
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Mastropasqua L, D’Aloisio R, Mastrocola A, Perna F, Cerino L, Cerbara L, Cruciani F, Toto L. Epidemiological Surveillance of Eye Disease and People Awareness in the Abruzzo Region, Italy. Medicina (Kaunas) 2021; 57:medicina57090978. [PMID: 34577901 PMCID: PMC8465192 DOI: 10.3390/medicina57090978] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/01/2021] [Accepted: 09/13/2021] [Indexed: 11/28/2022]
Abstract
Background and Objectives: Vision impairments and related blindness are major public health problems. The prevalence of eye disease and barriers to optimal care markedly vary among different geographic areas. In the Abruzzo region (central Italy), an epidemiological surveillance on the state of ocular health in the population aged over 50 years was performed in 2019. Materials and Methods: Participants were sampled to be representative of the region’s inhabitants. Data were collected through a telephone interview and an eye examination. Prevalence of cataract, glaucoma, retinopathy, and maculopathy was assessed. The Cohen’s kappa (k) was used to measure the agreement between the presence of eye disease and awareness of the disease by the participants. Results: Overall, 983 people with a mean age of 66.0 ± 9.5 years were included in the study. The prevalence of cataracts, glaucoma, maculopathy, and retinopathy was 52.6%, 5.3%, 5.6%, and 29.1%, respectively. Among the total of the affected people, those aware of their condition were 21.8% (k = 0.12, slight agreement) for cataract, 65.4% (k = 0.78, substantial agreement) for glaucoma, 7.1% (k = 0.10, slight agreement) for maculopathy, and 0% for retinopathy (k = −0.004, agreement lower than that expected by chance). Refractive defects were corrected in the vast majority of participants. Conclusion: In the Abruzzo region, about two thirds of citizens aged 50 years or over suffer from cataract, glaucoma, retinopathy, or maculopathy, which are recognized as leading causes of blindness. Many people with eye disease do not know they have it. These data can be used by clinicians and policymakers to undertake clinical, political, and social actions.
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Affiliation(s)
- Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
| | - Rossella D’Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
- Correspondence:
| | - Alessandra Mastrocola
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
| | - Fabiana Perna
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
- Italian National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired-WHOCC, IAPB Italy Onlus-FPG IRCCS, 00185 Roma, Italy;
| | - Luca Cerino
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
| | - Loredana Cerbara
- Institute for Research on Population and Social Policies, Italian National Research Council (CNR-IRPPS), 00185 Rome, Italy;
| | - Filippo Cruciani
- Italian National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired-WHOCC, IAPB Italy Onlus-FPG IRCCS, 00185 Roma, Italy;
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
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Gallenga CE, D’Aloisio R, D’Ugo E, Vecchiarino L, Agnifili L, Simonelli MB, Di Nicola M, Toto L, Perri P. Visual Performance and Quality of Life after Femtosecond Laser-Assisted Cataract Surgery with Trifocal IOLs Implantation. J Clin Med 2021; 10:jcm10143038. [PMID: 34300204 PMCID: PMC8307100 DOI: 10.3390/jcm10143038] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/15/2021] [Accepted: 06/28/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose: To assess visual performance and quality of life after implantation of diffractive trifocal IOLs with enhanced depth of focus (Acriva Reviol Tri-ED) compared to monofocal IOLs. Setting: Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d’Annunzio” Chieti-Pescara, Italy. Design: Prospective clinical study. Methods: This study comprised 36 eyes of 18 patients with senile cataract candidates for phacoemulsification and implantation of the Acriva Reviol Tri-ED (Group 1–18 eyes) and the AcrySof IQ Monofocal IOL SN60WF (Group 2–18 eyes). The main outcome measures, over a 6-month follow-up period, were uncorrected and corrected visual acuity at different distances (40, 60 cm and 4 m), defocus curve, contrast sensitivity and wavefront error. Patient satisfaction was evaluated by means of the NEI-RQL-42 questionnaire. Results: At 180 days postoperatively, the difference of the UCDVA and CDVA between the groups was not statistically significant (p = 0.888 and p = 0.843, respectively). The difference between the groups was statistically significant for UCIVA (p = 0.019) and UCNVA (p = 0.036). The mean values of contrast sensitivity under photopic and mesopic conditions were not significantly different between the groups. The RMS of spherical aberration was significantly lower in Group 1 compared to Group 2. The NEI-RQL-42 questionnaire showed statistically significant differences between the groups for the dependence on correction (p < 0.001). Conclusions: The diffractive trifocal IOL with enhanced depth of focus Acriva Reviol Tri-ED was effective in improving functional capacity for intermediate and near vision compared to monofocal IOLs and provided a good quality of vision due to a significant reduction in spherical aberration.
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Affiliation(s)
| | - Rossella D’Aloisio
- Department of Medicine and Aging Science, Ophthalmology Clinic, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (E.D.); (L.V.); (L.A.); (M.B.S.); (L.T.)
- Correspondence: ; Tel.: +39-08-71-35-8410; Fax: +39-08-71-35-8794
| | - Erminia D’Ugo
- Department of Medicine and Aging Science, Ophthalmology Clinic, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (E.D.); (L.V.); (L.A.); (M.B.S.); (L.T.)
| | - Luca Vecchiarino
- Department of Medicine and Aging Science, Ophthalmology Clinic, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (E.D.); (L.V.); (L.A.); (M.B.S.); (L.T.)
| | - Luca Agnifili
- Department of Medicine and Aging Science, Ophthalmology Clinic, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (E.D.); (L.V.); (L.A.); (M.B.S.); (L.T.)
| | - Maria Beatrice Simonelli
- Department of Medicine and Aging Science, Ophthalmology Clinic, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (E.D.); (L.V.); (L.A.); (M.B.S.); (L.T.)
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Experimental and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy;
| | - Lisa Toto
- Department of Medicine and Aging Science, Ophthalmology Clinic, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (E.D.); (L.V.); (L.A.); (M.B.S.); (L.T.)
| | - Paolo Perri
- Section of Ophthalmology, Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy;
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Toto L, Di Antonio L, Costantino O, Mastropasqua R. Anti-VEGF Therapy in Myopic CNV. Curr Drug Targets 2021; 22:1054-1063. [PMID: 33511955 DOI: 10.2174/1389450122999210128180725] [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] [Received: 05/23/2020] [Revised: 09/30/2020] [Accepted: 11/17/2020] [Indexed: 11/22/2022]
Abstract
In this narrative-review, we report the most recent data from the literature of anti-vascular endothelial growth factor treatment for myopic choroidal neovascularization (mCNV). Myopic CNV is the most frequent sight-threatening complication of pathologic myopia. The natural course of mCNV can result in expanding macular atrophy and /or fibrosis, leading to irreversible visual loss after 5 years. Retinal multimodal imaging is mandatory for early diagnosis and monitoring of the disease during treatment. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is recommended as the first-line treatment option for mCNV. Prompt treatment of active mCNV with intravitreal anti-VEGF therapy has been demonstrated to be effective in terms of visual outcome improvements reducing the occurrence of late-stage complications.
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Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Olivia Costantino
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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Borrelli E, Mastropasqua L, Souied E, Sadda S, Vella G, Toto L, Miere A, Corradetti G, Sacconi R, Ferro G, Sarraf D, Querques L, Mastropasqua R, Bandello F, Querques G. Longitudinal assessment of type 3 macular neovascularization using three-dimensional volume-rendering OCTA. Can J Ophthalmol 2021; 57:228-235. [PMID: 34058145 DOI: 10.1016/j.jcjo.2021.04.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/23/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate the evolution of treatment-naive type 3 macular neovascularization (MNV) undergoing anti-vascular endothelial growth factor (VEGF) treatment through volume rendered three-dimensional (3D) optical coherence tomography angiography (OCTA). DESIGN Retrospective observational study. PARTICIPANTS Patients with type 3 MNV and age-related macular degeneration (AMD). METHODS Included subjects had three loading injections of an anti-VEGF agent. The OCTA volume data at baseline and follow-up were processed with a previously published algorithm in order to obtain a volume-rendered representation of type 3 MNV. Progressive changes in type 3 lesions were analyzed via 3D OCTA volume rendering. RESULTS A total of 14 treatment-naive eyes with type 3 MNV from 11 AMD patients (7 females) were included. At both baseline and follow-up visits, a type 3 MNV complex was identifiable. Each complex was composed of a mean number of 2.5 ± 0.7 vascular branches at baseline and 1.4 ± 0.6 at the follow-up visit (p < 0.0001). The mean changes in central macular thickness and visual acuity were significantly correlated with modifications in the number of type 3 MNV branches (ρ = -0.533, p = 0.049, and ρ = -0.581, and p = 0.040, respectively). CONCLUSIONS This study demonstrated that type 3 lesions do not disappear completely after loading treatment, as indicated previously by histopathologic studies. Importantly, quantitative volume changes in type 3 lesions are directly associated with treatment response.
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Affiliation(s)
- Enrico Borrelli
- Vita-Salute San Raffaele University, Milan, Italy; San Raffaele Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Milan, Italy
| | - Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Eric Souied
- Department of Ophthalmology, University of Paris XII, Center Intercommunal de Creteil, Creteil, France
| | - SriniVas Sadda
- Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, Calif; Department of Ophthalmology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, Calif
| | - Giovanna Vella
- Vita-Salute San Raffaele University, Milan, Italy; San Raffaele Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Milan, Italy; Ophthalmology Unit, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Alexandra Miere
- Department of Ophthalmology, University of Paris XII, Center Intercommunal de Creteil, Creteil, France
| | - Giulia Corradetti
- Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, Calif; Department of Ophthalmology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, Calif
| | - Riccardo Sacconi
- Vita-Salute San Raffaele University, Milan, Italy; San Raffaele Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Milan, Italy
| | - Giada Ferro
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - David Sarraf
- Department of Ophthalmology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, Calif; Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California
| | - Lea Querques
- Vita-Salute San Raffaele University, Milan, Italy; San Raffaele Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Milan, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesco Bandello
- Vita-Salute San Raffaele University, Milan, Italy; San Raffaele Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Milan, Italy
| | - Giuseppe Querques
- Vita-Salute San Raffaele University, Milan, Italy; San Raffaele Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Milan, Italy; Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, Calif.
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Gallenga CE, Agnifili L, D’Aloisio R, Brescia L, Toto L, Perri P. Virtual learning solutions in COVID-19 era: University Italian Ophthalmology department perspective. Eur J Ophthalmol 2021; 32:11206721211015576. [PMID: 33977779 PMCID: PMC8935145 DOI: 10.1177/11206721211015576] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/14/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Few months after the COVID-19 pandemic burst, many aspects of the human life, including education, dramatically changed. Because of the lockdown measures taken to limit the virus spread in Italy, in-person teaching and learning have been interrupted in all health care disciplines and readapted in virtual formulae. METHODS As academic ophthalmology departments, we had to maintain the educational needs of medical and orthoptic students, internships, surgical training of residents, as well as to cover the scientific update of health care personnel (HCPs), and the continuation of research and academic activities. To assure these needs we ideated an educational strategy and a team, which was then translated on a multichannel virtual platform created with Microsoft Teams. RESULTS In this platform there were 21 channels organized in a public view mode, open to all Team members, or in private view mode to separate non-permanent HCPs, internships, residents, and students' tasks, from permanent HCPs tasks. Virtual channels were dedicated to provide theoretical lessons, clinical cases, surgical video, internal meetings and webinar, to offer news from scientific societies, requests of appointments from biomedical companies, links with ophthalmological websites, to move forward research projects, to participate at institutional academic duties, and to obtain feedbacks from users. Residents continued their training on surgery using a surgical simulator, after consulting an agenda uploaded into the dedicated virtual channel. CONCLUSION These positive initial results should represent a boost to rapidly proceed with the development of even more versatile virtual learning solutions, given that the forecasts for the duration of the COVID-19 pandemic are not encouraging.
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Affiliation(s)
| | - Luca Agnifili
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
| | - Rossella D’Aloisio
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
| | - Lorenza Brescia
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
| | - Paolo Perri
- Department of Neuroscience and Rehabilitation, Section of Ophthalmology, University of Ferrara, Ferrara, Italy
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Toto L, Carpineto P, Falconio G, Agnifili L, Di nicola M, Mastropasqua A, Mastropasqua L. Comparative study of Acrysof ReSTOR multifocal intraocular lenses +4.00 D and +3.00 D: visual performance and wavefront error. Clin Exp Optom 2021. [DOI: 10.1111/j.1444-0938.2012.00815.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Lisa Toto
- Department of Medicine and Science of Ageing, Eye Clinic, University “G. d'Annunzio”, Chieti, Italy,
| | - Paolo Carpineto
- Department of Medicine and Science of Ageing, Eye Clinic, University “G. d'Annunzio”, Chieti, Italy,
| | - Gennaro Falconio
- Department of Medicine and Science of Ageing, Eye Clinic, University “G. d'Annunzio”, Chieti, Italy,
| | - Luca Agnifili
- Department of Medicine and Science of Ageing, Eye Clinic, University “G. d'Annunzio”, Chieti, Italy,
| | - Marta Di nicola
- Fondazione Università “G. d'Annunzio”, Center of Excellence on Aging, Department of Biomedical Science, University “G. d'Annunzio”, Laboratory of Biostatistics, Chieti, Italy,
| | - Alessandra Mastropasqua
- Department of Medicine and Science of Ageing, Eye Clinic, University “G. d'Annunzio”, Chieti, Italy,
| | - Leonardo Mastropasqua
- Department of Medicine and Science of Ageing, Eye Clinic, University “G. d'Annunzio”, Chieti, Italy,
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Mastropasqua R, D’Aloisio R, Costantini E, Porreca A, Ferro G, Libertini D, Reale M, Di Nicola M, Viggiano P, Falconio G, Toto L. Serum microRNA Levels in Diabetes Mellitus. Diagnostics (Basel) 2021; 11:diagnostics11020284. [PMID: 33670401 PMCID: PMC7918507 DOI: 10.3390/diagnostics11020284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 12/20/2020] [Revised: 01/29/2021] [Accepted: 02/06/2021] [Indexed: 12/15/2022] Open
Abstract
The aim of our study is to evaluate the serum circulating levels of some miRNA, such as hsa-let-7b-5p, hsa-let-7a-5p, hsa-miR-320b, hsa-miR-23a-3p, hsa-miR-27a-3p, hsa-miR-15a-5p, and hsa-miR-495-3, in diabetic patients without diabetic retinopathy (DR), diabetic patients with DR, and, healthy subjects in order to find reliable and reproducible biomarkers for DR. A total of 45 subjects underwent serum sampling for miRNAs evaluation and a complete ophthalmologic examination, including microperimetry and widefield swept source optical coherence tomography angiography (OCTA). Total circulating RNA was isolated from patients using the miRNeasy Serum/Plasma Kit. Serum miRNA expression levels were significantly different in the three groups. In detail, circulating hsa-miR-15a-5p levels were significantly reduced in both diabetic patients without DR and diabetic patients with DR (p = 0.027). Serum hsa-miR-495-3p was lower in diabetic patients with DR and diabetic patients without DR (p = 0.049). Hsa-miR-23a-3p serum expression levels were significantly lower in diabetic patients with DR and diabetic patients without DR (p = 0.013). Significant associations of miRNAs with anatomical/perfusion parameters and functional parameters were observed in the diabetic groups. We find evidence of damage in progression biomarkers in DR that are evidently early in patients with diabetes without DR. Serum miRNAs levels are considered to have strong potential as a novel biomarker for the early detection of DR in subjects suffering from diabetes and could represent noninvasive target therapies to block the progression of the disease at the early stages.
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Affiliation(s)
- Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Rossella D’Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (G.F.); (D.L.); (P.V.); (G.F.); (L.T.)
- Correspondence:
| | - Erica Costantini
- Department of Medical, Oral and Biotechnological Science, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (E.C.); (M.R.); (M.D.N.)
| | - Annamaria Porreca
- Department of Economic Studies, University “G. d’Annunzio” Chieti-Pescara, Viale Pindaro, 65100 Pescara, Italy;
| | - Giada Ferro
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (G.F.); (D.L.); (P.V.); (G.F.); (L.T.)
| | - Daniele Libertini
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (G.F.); (D.L.); (P.V.); (G.F.); (L.T.)
| | - Marcella Reale
- Department of Medical, Oral and Biotechnological Science, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (E.C.); (M.R.); (M.D.N.)
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Science, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (E.C.); (M.R.); (M.D.N.)
| | - Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (G.F.); (D.L.); (P.V.); (G.F.); (L.T.)
| | - Gennaro Falconio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (G.F.); (D.L.); (P.V.); (G.F.); (L.T.)
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (G.F.); (D.L.); (P.V.); (G.F.); (L.T.)
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Viggiano P, Toto L, Ferro G, Evangelista F, Porreca A, Mastropasqua R. Choroidal structural changes in different intermediate AMD patterns. Eur J Ophthalmol 2021. [PMID: 33506710 DOI: 10.1177/1120672121992009.] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To report variation of choroidal thickness (CT) and choroidal vascularity index (CVI) in subjects with drusen and subjects with reticular pseudodrusen (RPD) compared with healthy individuals using the Spectral-domain (SD)-Optical Coherence Tomography with enhanced depth imaging (EDI) system. DESIGN A prospective, observational, cross-sectional study. SUBJECTS Eighty-four participants. METHODS The patients were imaged using the Heidelberg Spectralis device (Heidelberg Engineering, Heidelberg, Germany) with EDI mode. EDI-OCT images were exported and then imported into image analysis ImageJ software (National Institutes of Health, Bethesda) and a semiautomated algorithm was used for subsequent quantitative analysis. MAIN OUTCOME MEASURES This study evaluated two choroidal parameters: (i) choroidal thickness (CT); (ii) choroidal vascularity index (CVI). RESULTS CT analysis was performed in three different regions: (i) foveal region, (ii) parafoveal region; (iii) perifoveal region. All the analyzed regions were significantly decreased in RPD pattern, as compared with both the drusen group (p < .005) and healthy eyes (p < .005). CVI was significantly decreased in the RPD pattern, as compared with healthy eyes (p < 0.001). However, the drusenoid pattern did not have statistical significance in comparison with the control group suggesting the lower incidence of this pattern on choroidal vasculopathy. CONCLUSIONS We report CT and CVI difference in RPD and drusen eyes. The RPD pattern seems to be a consequence of an alteration in the choroidal vascularity resulting in severe ischemia and excessive hypoxia inducing an increased risk of late AMD compared to the drusenoid pattern.
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Affiliation(s)
- Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Giada Ferro
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Annamaria Porreca
- Department of Economic Studies, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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Viggiano P, Toto L, Ferro G, Evangelista F, Porreca A, Mastropasqua R. Choroidal structural changes in different intermediate AMD patterns. Eur J Ophthalmol 2021; 32:460-467. [PMID: 33506710 DOI: 10.1177/1120672121992009] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 12/26/2022]
Abstract
PURPOSE To report variation of choroidal thickness (CT) and choroidal vascularity index (CVI) in subjects with drusen and subjects with reticular pseudodrusen (RPD) compared with healthy individuals using the Spectral-domain (SD)-Optical Coherence Tomography with enhanced depth imaging (EDI) system. DESIGN A prospective, observational, cross-sectional study. SUBJECTS Eighty-four participants. METHODS The patients were imaged using the Heidelberg Spectralis device (Heidelberg Engineering, Heidelberg, Germany) with EDI mode. EDI-OCT images were exported and then imported into image analysis ImageJ software (National Institutes of Health, Bethesda) and a semiautomated algorithm was used for subsequent quantitative analysis. MAIN OUTCOME MEASURES This study evaluated two choroidal parameters: (i) choroidal thickness (CT); (ii) choroidal vascularity index (CVI). RESULTS CT analysis was performed in three different regions: (i) foveal region, (ii) parafoveal region; (iii) perifoveal region. All the analyzed regions were significantly decreased in RPD pattern, as compared with both the drusen group (p < .005) and healthy eyes (p < .005). CVI was significantly decreased in the RPD pattern, as compared with healthy eyes (p < 0.001). However, the drusenoid pattern did not have statistical significance in comparison with the control group suggesting the lower incidence of this pattern on choroidal vasculopathy. CONCLUSIONS We report CT and CVI difference in RPD and drusen eyes. The RPD pattern seems to be a consequence of an alteration in the choroidal vascularity resulting in severe ischemia and excessive hypoxia inducing an increased risk of late AMD compared to the drusenoid pattern.
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Affiliation(s)
- Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Giada Ferro
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Annamaria Porreca
- Department of Economic Studies, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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Di Antonio L, Viggiano P, Ferro G, Toto L, D’Aloisio R, Porreca A, Di Nicola M, Mastropasqua R. Retinal vascular metrics difference by comparison of two image acquisition modes using a novel OCT angiography prototype. PLoS One 2020; 15:e0243074. [PMID: 33259557 PMCID: PMC7707478 DOI: 10.1371/journal.pone.0243074] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 11/15/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To assess the different impact of two enface OCTA image simultaneously acquired by means of a new prototype of Spectral-Domain Optical Coherence Tomography Angiography (SD-OCTA) on quantitative retinal vascular metrics. METHODS In this prospective observational cross-sectional study 28 healthy subjects were enrolled. Macular (3x3 mm) OCTA images were acquired for all participants using Solix Fullrange OCT (Optovue Inc, Freemont CA, USA). The main outcome measurements were: Perfusion density (PD), vessel length density (VLD), and vessel diameter index (VDI) of both superficial capillary plexus (SCP) and deep capillary plexus (DCP), and choriocapillaris (CC) total flow-deficits area. Quantitative retinal vascular metrics were measured on binarized and skeletonized OCTA images by comparing not averaged and fast automated multiple averaged en face OCTA images. RESULTS In both SCP and DCP, PD significantly increased (p = 0,005 and p = 0,030, respectively), and VLD significantly decreased (p<0,001 and p = 0,004, respectively), and VDI increased (p<0,001 and p = 0,068, respectively), and total CC flow deficits area significantly decreased (p<0,001) by averaging multiple OCTA images. CONCLUSIONS In this study, we found a significant difference of quantitative retinal metrics by comparing two different image acquisition modes using a novel and fully automated averaging OCTA system in young healthy subjects.
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Affiliation(s)
- Luca Di Antonio
- UOC Ophthalmology ASL-1 Avezzano-Sulmona-L’Aquila, L’Aquila, Italy
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University G. d’Annunzio Chieti-Pescara, Chieti, Italy
| | - Pasquale Viggiano
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University G. d’Annunzio Chieti-Pescara, Chieti, Italy
- * E-mail:
| | - Giada Ferro
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University G. d’Annunzio Chieti-Pescara, Chieti, Italy
| | - Lisa Toto
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University G. d’Annunzio Chieti-Pescara, Chieti, Italy
| | - Rossella D’Aloisio
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University G. d’Annunzio Chieti-Pescara, Chieti, Italy
| | - Annamaria Porreca
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Department of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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Borrelli E, Toto L, Viggiano P, Evangelista F, Palmieri M, Mastropasqua R. Widefield topographical analysis of the retinal perfusion and neuroretinal thickness in healthy eyes: a pilot study. Eye (Lond) 2020; 34:2264-2270. [PMID: 32055020 PMCID: PMC7784843 DOI: 10.1038/s41433-020-0804-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 01/01/2019] [Revised: 10/31/2019] [Accepted: 11/16/2019] [Indexed: 01/22/2023] Open
Abstract
PURPOSE In this pilot study we reported variation of superficial (SCP) and deep (DCP) capillary plexuses flow in macular and near/mid periphery regions in healthy subjects using widefield swept source-optical coherence tomography angiography (SS-OCTA). METHODS In this prospective, cross-sectional study, enroled subjects were imaged with an SS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). OCTA scans were taken in primary and extremes of gaze and a montage was automatically created. Quantitative analysis was performed in the macular and peripheral regions. In addition, SCP and DCP variables were further investigated in distinct fields within these three different regions. RESULTS Fifty-five young healthy subjects (55 eyes) were enroled. The retinal periphery displayed a higher SCP perfusion density (39.6 ± 1.7% and 40.7 ± 1.4%, P < 0.0001) and SCP vessel diameter index (3.5 ± 0.2 and 3.6 ± 0.2, P < 0.0001), in comparison with the macular region. At the DCP level, the retinal periphery was characterized by a lower perfusion density (41.6 ± 3.7% and 37.9 ± 2.9%, P < 0.0001) and vessel length density (14.6 ± 6.0% and 9.9 ± 2.6%, P < 0.0001). In the analysis investigating the DCP in the retinal periphery, the temporal sector was characterized by a reduction in perfusion density, vessel length density, and vessel diameter index. In univariate analysis, the retinal thickness was found to have a significant direct relationship with DCP perfusion density (P < 0.0001), but not with SCP perfusion density (P = 0.712). CONCLUSIONS We report quantitative mapping of the SCP and DCP in healthy individuals. The DCP perfusion appears to have a wide topographical variation, which is strictly dependent on the retinal thickness.
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Affiliation(s)
- Enrico Borrelli
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Michele Palmieri
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
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Mastropasqua R, Evangelista F, Amodei F, D'Aloisio R, Pinto F, Doronzo E, Viggiano P, Porreca A, Di Nicola M, Parravano M, Toto L. Optical Coherence Tomography Angiography in Macular Neovascularization: A Comparison Between Different OCTA Devices. Transl Vis Sci Technol 2020; 9:6. [PMID: 33101783 PMCID: PMC7545059 DOI: 10.1167/tvst.9.11.6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/13/2020] [Accepted: 08/16/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study is to compare the ability of 3 optical coherence tomography angiography (OCTA) devices to measure lesion area in patients with macular neovascularization (MNV) with type 1, 2 and mixed neovascularization (NV). Methods OCTA, fluorescein angiography (FA), indocyanine green angiography (ICGA), and structural optical coherence tomography (OCT) were performed. NV lesion area measurements were performed by two graders. Results Twenty-eight eyes were included: 20 with NV were classified as type 1, 6 as type 2, and 2 as mixed type. AngioVue and Spectralis detected the NV in 26 out of 28 eyes (92.8%). The intraclass correlation coefficient (ICC) between readers for the three different OCTA with the different slabs was high. The NV area was larger in the outer retina to choriocapillaris (ORCC) and choriocapillaris (CC) images for the AngioVue device and the PLEX Elite device compared to avascular images (P < 0.05). The mean values of the NV area were not significantly different among the three instruments (Friedman test, P > 0.05) for the avascular zone (AV), ORCC, and CC images. Median (interquartile range [IQR]) NV were significantly different among avascular images, ORCC images, and CC images of the AngioVue device (P = 0.046), of the Spectralis device (P = 0.015), and the PLEX Elite device (P < 0.001). Conclusions The ORCC slabs showed the highest detection rate for NV detection independently to the device used, and swept source (SS)-OCTA measurements of ORCC slabs showed the highest detection rate of NVs compared to the spectral domain (SD)-OCTA. Translational Relevance It is pivotal to realize how much we can rely on OCTA to make a diagnosis of NV.
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Affiliation(s)
- Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Federica Evangelista
- Ophthalmic Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Francesco Amodei
- Ophthalmic Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Rossella D'Aloisio
- Ophthalmic Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Filomena Pinto
- Ophthalmic Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Emanuele Doronzo
- Ophthalmic Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Pasquale Viggiano
- Ophthalmic Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Annamaria Porreca
- Department of Economic Studies, University "G. D'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Marta Di Nicola
- Department of Economic Studies, University "G. D'Annunzio" Chieti-Pescara, Chieti, Italy
| | | | - Lisa Toto
- Ophthalmic Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
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Toto L, D'Aloisio R, Chiarelli AM, Di Antonio L, Evangelista F, D'Onofrio G, Merla A, Parravano M, Di Marzio G, Mastropasqua R. A Custom-Made Semiautomatic Analysis of Retinal Nonperfusion Areas After Dexamethasone for Diabetic Macular Edema. Transl Vis Sci Technol 2020; 9:13. [PMID: 32832220 PMCID: PMC7414703 DOI: 10.1167/tvst.9.7.13] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 01/30/2020] [Accepted: 03/29/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the changes of retinal capillary nonperfusion areas and retinal capillary vessel density of the superficial capillary plexus (SCP) and deep capillary plexus in patients with diabetes with diabetic macular edema treated with an intravitreal dexamethasone implant (IDI). Methods We enrolled 28 patients with diabetic retinopathy and diabetic macular edema candidates to IDI. All patients underwent widefield optical coherence tomography angiography with PLEX Elite 9000 device with 15 × 9 mm scans centered on the foveal center at baseline, 1 month, 2 months, and 4 months after IDI. In all the patients, the variation of the retinal capillary nonperfusion areas and of the retinal vessel density of the SCP and deep capillary plexus were calculated using an automatic software written in Matlab (MathWorks, Natick, MA). Results During follow-up, SCP showed a statistically significant reduction of ischemic areas at 1 month after IDI (P = 0.04) and slightly increased not significantly thereafter (P = 0.15). The percentage of nonperfusion areas changed from 11.4% at baseline, to 6.3% at 1 month, 8.1%, at 2 months, and 10.2% at 4 months. The whole vessel density of SCP slightly increased (not significantly) from 35.30% at baseline to 38.00% at 1 month, and then decreased to 37.85% at 2 months and 36.04% at 4 months (P = 0.29). Retinal capillary nonperfusion areas and retinal vessel density at the deep capillary plexus did not change significantly (P = 0.31 and P = 0.73, respectively). Conclusions Widefield optical coherence tomography angiography showed a decrease in retinal capillary nonperfusion areas after dexamethasone implant suggesting a possible drug-related reperfusion of retinal capillaries particularly evident in the early period. Translational Relevance A custom-made automatic analysis of retinal nonperfusion areas may allow a better and precise evaluation of ischemic changes after intravitreal therapy.
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Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Antonio Maria Chiarelli
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Giada D'Onofrio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Arcangelo Merla
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | | | - Guido Di Marzio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Via del Pozzo 71, 41125, Italy
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Mastropasqua L, D'Aloisio R, Brescia L, Lanzini M, Bondì J, Libertini D, Mastropasqua R, D'Onofrio G, Zuppardi E, Toto L, Agnifili L. Teleophthalmology in COVID-19 era: an Italian ophthalmology department experience. Eye (Lond) 2020; 35:2319-2321. [PMID: 32811998 PMCID: PMC7433276 DOI: 10.1038/s41433-020-01135-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/06/2020] [Accepted: 08/07/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Leonardo Mastropasqua
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University "G. d'Annunzio" Chieti-Pescara, Chieti, 66100, Italy
| | - Rossella D'Aloisio
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University "G. d'Annunzio" Chieti-Pescara, Chieti, 66100, Italy.
| | - Lorenza Brescia
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University "G. d'Annunzio" Chieti-Pescara, Chieti, 66100, Italy
| | - Manuela Lanzini
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University "G. d'Annunzio" Chieti-Pescara, Chieti, 66100, Italy
| | - Jessica Bondì
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University "G. d'Annunzio" Chieti-Pescara, Chieti, 66100, Italy
| | - Daniele Libertini
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University "G. d'Annunzio" Chieti-Pescara, Chieti, 66100, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, 42121, Italy
| | - Giada D'Onofrio
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University "G. d'Annunzio" Chieti-Pescara, Chieti, 66100, Italy
| | - Eduardo Zuppardi
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University "G. d'Annunzio" Chieti-Pescara, Chieti, 66100, Italy
| | - Lisa Toto
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University "G. d'Annunzio" Chieti-Pescara, Chieti, 66100, Italy
| | - Luca Agnifili
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University "G. d'Annunzio" Chieti-Pescara, Chieti, 66100, Italy
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Bonfiglio V, Ortisi E, Scollo D, Reibaldi M, Russo A, Pizzo A, Faro G, Macchi I, Fallico M, Toro MD, Rejdak R, Nowomiejska K, Toto L, Rinaldi M, Cillino S, Avitabile T, Longo A. Vascular changes after vitrectomy for rhegmatogenous retinal detachment: optical coherence tomography angiography study. Acta Ophthalmol 2020; 98:e563-e569. [PMID: 31773840 DOI: 10.1111/aos.14315] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [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: 06/28/2019] [Accepted: 10/31/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE To analyse the postoperative foveal avascular zone (FAZ) area, superficial vessel density (SVD) and deep vessel density (DVD) and their correlation with functional (best-corrected visual acuity, BCVA) and anatomical outcomes (foveal macular thickness, FMT) after surgery for rhegmatogenous retinal detachment (RRD) repair. METHOD Patients with RRD eyes, successfully treated with a single pars plana vitrectomy (PPV) with gas tamponade and a minimum 12 months follow-up, were re-examined. Foveal avascular zone (FAZ) area, SVD, DVD and FMT were evaluated by using optical coherence tomography angiography (OCTA) and compared to fellow eye. RESULTS Fifty-six patients with macula-on and 37 with macula-off RRD were included in the study. In both groups, no difference in FMT and FAZ area was found compared to fellow eyes. In macula-on RRD eyes, a lower parafoveal DVD (p = 0.001) was detected; FAZ area was related to FMT (p = 0.025), and the postoperative BCVA was correlated with parafoveal DVD (p = 0.010) and FAZ area (p = 0.003). In macula-off RRD eyes, lower parafoveal SDV (p = 0.012), and foveal and parafoveal DVD (p = 0.012 and p < 0.001, respectively) were observed. BCVA was related to FAZ area (p = 0.012), foveal SVD (p = 0.005) and parafoveal DVD (p = 0.010). CONCLUSION Rhegmatogenous retinal detachment eyes successfully treated with PPV had lower vessel density in the superficial and deep retinal plexus compared to fellow healthy eyes; BCVA was related to FAZ area and vessel density.
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Affiliation(s)
| | - Elina Ortisi
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Davide Scollo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Michele Reibaldi
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Andrea Russo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Alessandra Pizzo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Giuseppe Faro
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Iacopo Macchi
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Matteo Fallico
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Mario D Toro
- Department of Ophthalmology, University of Catania, Catania, Italy.,Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Robert Rejdak
- Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland
| | | | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Michele Rinaldi
- Department of Ophthalmology, Second University of Napoli, Naples, Italy
| | - Salvatore Cillino
- Department of Experimental Biomedicine and Clinical Neuroscience, Ophthalmology Section, University of Palermo, Palermo, Italy
| | | | - Antonio Longo
- Department of Ophthalmology, University of Catania, Catania, Italy
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D’Aloisio R, Viggiano P, Borrelli E, Parravano M, Agbèanda AG, Evangelista F, Ferro G, Toto L, Mastropasqua R. Changes in Iris Perfusion Following Scleral Buckle Surgery for Rhegmatogenous Retinal Detachment: An Anterior Segment Optical Coherence Tomography Angiography (AS-OCTA) Study. J Clin Med 2020; 9:jcm9041231. [PMID: 32344742 PMCID: PMC7231266 DOI: 10.3390/jcm9041231] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/19/2020] [Accepted: 04/21/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose: To investigate iris vasculature changes following scleral buckling (SB) surgery in eyes with rhegmatogenous retinal detachment (RRD) with anterior-segment (AS) optical coherence tomography angiography (OCTA). Methods: In this prospective study, enrolled subjects were imaged with an SS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). Image acquisition of the iris was obtained using an AS lens and a manual focusing adjustment in the iris using the retina imaging software. The quantitative analysis was performed in eight different iris regions: (i) superior, (ii) supero-temporal, (iii) supero-nasal, (iv) nasal, (v) temporal, (vi) inferior, (vii) infero-temporal, (viii) infero nasal which, were defined as squares with area of 1.5 mm2. Results: Fifteen eyes of 15 patients (six females; nine males) were included. Anterior segment optical coherence tomography angiography (AS-OCTA) parameters of the iris were statistically compared at baseline (preoperatively), 1 week, 1 month and 6 months after SB. At post-operative 1 week, perfusion density (PD) showed a significant decrease from 66.8 ± 13.2% to 58.55 ± 12.0% in the iris supero-nasal region (p = 0.016). However, at the 1-month follow-up visit, iris PD was significantly lower in all the analyzed iris regions, apart from the superior one. Conclusions: This study is the first description of AS-OCTA in patients undergoing SB. Our results showed a uniform reduction of the iris vessel network at 1 month after surgery, supporting the clinical use of AS-OCTA to identify early iris perfusion changes as potential predictive biomarkers of vascular disorders.
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Affiliation(s)
- Rossella D’Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (R.D.); (E.B.); (A.-G.A.); (F.E.); (G.F.); (L.T.)
| | - Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (R.D.); (E.B.); (A.-G.A.); (F.E.); (G.F.); (L.T.)
- Correspondence: ; Tel.: +39-08-7135-8410; Fax: +39-08-7135-7294
| | - Enrico Borrelli
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (R.D.); (E.B.); (A.-G.A.); (F.E.); (G.F.); (L.T.)
| | - Mariacristina Parravano
- IRCCS Fondazione G.B.Bietti per lo Studio e la Ricerca in Oftalmologia ONLUS, 00198 Roma, Italy;
| | - Aharrh-Gnama Agbèanda
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (R.D.); (E.B.); (A.-G.A.); (F.E.); (G.F.); (L.T.)
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (R.D.); (E.B.); (A.-G.A.); (F.E.); (G.F.); (L.T.)
| | - Giada Ferro
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (R.D.); (E.B.); (A.-G.A.); (F.E.); (G.F.); (L.T.)
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (R.D.); (E.B.); (A.-G.A.); (F.E.); (G.F.); (L.T.)
| | - Rodolfo Mastropasqua
- Facoltà di Medicina e Chirurgia dell’Università di Modena e Reggio Emilia, 41121 Modena, Italy;
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Borrelli E, Viggiano P, Evangelista F, Toto L, Mastropasqua R. Eyelashes Artifact in Ultra-Widefield Optical Coherence Tomography Angiography. Ophthalmic Surg Lasers Imaging Retina 2020; 50:740-743. [PMID: 31755975 DOI: 10.3928/23258160-20191031-11] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/26/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND OBJECTIVE To describe the presence of eyelashes artifact in ultra-widefield swept-source optical coherence tomography angiography (SS-OCTA) images. PATIENTS AND METHODS In this prospective, cross-sectional study, 52 healthy, young subjects were imaged with the SS-OCTA system. OCTA scans were taken in primary and extremes of gaze, and a montage was automatically created. The en face choriocapillaris images were then exported, and a semi-automated algorithm was used for subsequent quantitative analysis. RESULTS The authors noted the presence of some linear regions of reduced brightness, which were assumed to represent a shadow effect due to patient eyelashes. In order to quantify this effect, the authors performed a quantitative analysis of the superior and inferior regions in the retinal and choroidal vessels. CONCLUSIONS The authors' qualitative and quantitative analysis showed the presence of regions of false-positive hypoperfusion secondary to eyelashes artifacts. To the authors' knowledge, this represents the first description of this new type of shadowing artifact affecting OCTA images. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:740-743.].
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Toto L, Evangelista F, Viggiano P, Erroi E, D'Onofrio G, Libertini D, Porreca A, D'Aloisio R, Mariacristina P, Di Antonio L, Di Nicola M, Mastropasqua R. Changes in Ocular Blood Flow after Ranibizumab Intravitreal Injection for Diabetic Macular Edema Measured Using Laser Speckle Flowgraphy. Biomed Res Int 2020; 2020:9496242. [PMID: 32104710 PMCID: PMC7035512 DOI: 10.1155/2020/9496242] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the effects of intravitreal ranibizumab (IVR) treatment on the blood flow of the optic nerve head (ONH) and of retinal vessels of the peripapillary region of eyes with diabetic macular edema (DME) assessed using laser speckle flowgraphy (LSFG). METHODS Forty eyes of 30 patients treated with IVR for DME were included in this prospective clinical study. Mean blur rate (MBR) and relative flow volume (RFV) of the ONH and of a superior retinal artery and an inferior retinal vein of the peripapillary region were measured using LSFG at baseline, 2 weeks (T1), and 1 month (T2) after IVR injection. In addition, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were measured in all cases. RESULTS The BCVA improved and CRT decreased significantly during the follow-up period (p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA. CONCLUSION IVR injection leads to a reduction of ocular blood flow both in the ONH and in the retinal peripapillary vessels associated with peripapillary vessel constriction. The reduction of CRT and related improvement of vision may be related to the changes in ocular blood flow.
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Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Emanuele Erroi
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Giada D'Onofrio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Daniele Libertini
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Annamaria Porreca
- Department of Economic Studies, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | | | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Via dei Vestini 31, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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Mastropasqua L, Perilli R, D'Aloisio R, Toto L, Mastropasqua A, Donato S, Taraborrelli M, Ginestra F, Porta M, Consoli A. Why Miss the Chance? Incidental Findings while Telescreening for Diabetic Retinopathy. Ophthalmic Epidemiol 2020; 27:237-245. [PMID: 31958252 DOI: 10.1080/09286586.2020.1715450] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/10/2023]
Abstract
PURPOSE To report on incidental pathological findings met while screening for Diabetic Retinopathy (DR) in Diabetes Clinics (DC) by ophthalmologist-graded digital fundus imaging. METHODS At the DC of Pescara (central Italy), for 3,859 eyes of 1,930 consecutive patients having not undergone fundus examination in the last year, two mydriatic fundus digital images, taken with a CenterVue DRS Digital Retinal Camera, were sent along with Best Corrected Visual Acuity, on a "store-and-forward" basis, to an ophthalmologist trained in DR screening, and graded according to the UK Diabetic Eye Screening Programme. Incidental fundus abnormalities other than DR were reported. RESULTS No adverse event to mydriasis was reported. One hundred and eighty eyes (4.66%) were ungradable. Among the 3,679 gradable ones, 1,105 (30.04%) showed different degrees of DR (R1 to R3), and 126 (3.42%) maculopathy (M1). Any Age-Related Macular Degeneration was present in 387 eyes (10.52%), any optic disc and parapapillary area features suspect for glaucoma in 562 eyes (15.27%), any hypertensive retinopathy in 1,263 eyes (34.33%), vitreoretinal interface disease in 252 eyes (6.84%), myopic choroidopathy in 92 eyes (2.50%), disc pallor in 31 eyes (0.84%). Mean time was 5 min for screening, 2 min for grading. CONCLUSION Teleretinography is a well-established, cost-effective procedure in DR screening. Along with increased attendance, locating a digital camera in a DC with a retina-specialist grader results in finding fundus pathologies also beyond DR, very similarly to fundus examination in an outpatient ophthalmic setting.
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Affiliation(s)
- Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara , Chieti, Italy
| | - Roberto Perilli
- Territorial Ophthalmology Unit, Local Health Authority , Pescara, Italy
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara , Chieti, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara , Chieti, Italy
| | - Alessandra Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara , Chieti, Italy
| | - Simone Donato
- Chair of Endocrinology and Metabolic Diseases, University G. d'Annunzio Chieti-Pescara , Chieti, Italy
| | - Merilda Taraborrelli
- Chair of Endocrinology and Metabolic Diseases, University G. d'Annunzio Chieti-Pescara , Chieti, Italy
| | - Federica Ginestra
- Chair of Endocrinology and Metabolic Diseases, University G. d'Annunzio Chieti-Pescara , Chieti, Italy
| | - Massimo Porta
- Chair of Internal Medicine, Department Of Medical Sciences, University of Turin , Turin, Italy
| | - Agostino Consoli
- Chair of Endocrinology and Metabolic Diseases, University G. d'Annunzio Chieti-Pescara , Chieti, Italy
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Mastropasqua R, D’Aloisio R, De Nicola C, Ferro G, Senatore A, Libertini D, Di Marzio G, Di Nicola M, Di Martino G, Di Antonio L, Toto L. Widefield Swept Source OCTA in Retinitis Pigmentosa. Diagnostics (Basel) 2020; 10:diagnostics10010050. [PMID: 31963847 PMCID: PMC7167867 DOI: 10.3390/diagnostics10010050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 12/04/2019] [Revised: 01/09/2020] [Accepted: 01/13/2020] [Indexed: 12/12/2022] Open
Abstract
(1) Background: To evaluate superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris (CC), perfusion density (PD), and vessel length density (VLD) in macular and near/mid periphery regions in patients with retinitis pigmentosa (RP) using widefield swept source optical coherence tomography angiography (WSS-OCTA). (2) Methods: Twelve RP patients (20 eyes) and 20 age-matched subjects (20 eyes) were imaged with the SS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). Quantitative analysis was performed in the macular and peripheral regions. The main outcome measures were SCP, DCP, CC, PD, and VLD in central and peripheral areas. (3) Results: Mean visual acuity, central macular thickness, and microperimetry were significantly reduced in RP patients compared to normal subjects (p < 0.05). The perfusion density and VLD of SCP, DCP, and CC were significantly reduced in RP patients compared to normal controls both in the central and peripheral retina (p < 0.05). A significant direct correlation was found in RP patients between PD of the 1.5 mm central retina both in DCP and CC and microperimetry at 4° and 8°. (4) Conclusions: Widefield SS-OCTA shows an impairment of retinal and choroidal perfusion density and vessel length density in central and peripheral retina of RP patients. The reduction of flow features correlates with the macular function.
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Affiliation(s)
- Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Via Università, 4, 41121 Modena (MO), Italy;
| | - Rossella D’Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (C.D.N.); (G.F.); (A.S.); (D.L.); (G.D.M.); (L.D.A.); (L.T.)
- Correspondence: ; Tel.: +39-0871358410
| | - Chiara De Nicola
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (C.D.N.); (G.F.); (A.S.); (D.L.); (G.D.M.); (L.D.A.); (L.T.)
| | - Giada Ferro
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (C.D.N.); (G.F.); (A.S.); (D.L.); (G.D.M.); (L.D.A.); (L.T.)
| | - Alfonso Senatore
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (C.D.N.); (G.F.); (A.S.); (D.L.); (G.D.M.); (L.D.A.); (L.T.)
- Duke University Eye Center, Center for Retinal Degenerations and Ophthalmic Genetic Diseases, Durham, NC 27705, USA
| | - Daniele Libertini
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (C.D.N.); (G.F.); (A.S.); (D.L.); (G.D.M.); (L.D.A.); (L.T.)
| | - Guido Di Marzio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (C.D.N.); (G.F.); (A.S.); (D.L.); (G.D.M.); (L.D.A.); (L.T.)
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy;
| | - Giuseppe Di Martino
- Department of Medicine and Science of Ageing, School of Hygiene and Preventive Medicine, University G. D’Annunzio Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy;
| | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (C.D.N.); (G.F.); (A.S.); (D.L.); (G.D.M.); (L.D.A.); (L.T.)
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (C.D.N.); (G.F.); (A.S.); (D.L.); (G.D.M.); (L.D.A.); (L.T.)
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Mastropasqua R, Viggiano P, Borrelli E, Evangelista F, Libertini D, Di Antonio L, Toto L. In Vivo Mapping of the Choriocapillaris in High myopia: a Widefield Swept Source Optical Coherence Tomography Angiography. Sci Rep 2019; 9:18932. [PMID: 31831754 PMCID: PMC6908654 DOI: 10.1038/s41598-019-55192-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 05/28/2019] [Accepted: 11/18/2019] [Indexed: 01/08/2023] Open
Abstract
To report variation of choriocapillaris (CC) flow in widefield in high in myopic subjects compared with an age-matched normal control group using ultra widefield optical coherence tomography angiography (UW-OCTA). This is a Prospective, cross-sectional study. Thirty high myopia subjects and fifty healthy subjects were enrolled. Healthy and high myopia subjects were imaged with the SS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). For each eye, five 12 × 12-mm OCTA volume scans were acquired. The en face CC images were then exported to imageJ and a semi-automated algorithm was used for subsequent quantitative analysis. The main outcome was a quantitative analysis of the CC. This analysis was performed in three different regions: (i) peripapillary, (ii) macular, and (iii) periphery. In addition, CC variables were further investigated in distinct fields within these three different regions. Thirty myopic eyes (32 subjects; myopic group) and fifty eyes (50 subjects; control group) without elevated myopia were included in the analysis. Mean ± SD age was 26.9 ± 2.9 years [median: 27 years; range: 20.0–40.0 years]. Mean ± SD axial length was 26.6 ± 0.6 mm [median: 26.2 mm; range: 26.1 to 28.0 mm]. Mean ± SD axial length was 26.6 ± 0.6 mm [median: 26.2 mm; range: 26.1 to 28.0 mm] in the myopic group and 23.9 ± 1.1 mm [median: 23.9 mm; range: 21.8 to 25.9 mm] in the control group. The total signal void area was significantly greater in myopic eyes compared with control group. The peripapillary region exhibited the greatest total signal void area (p < 0.0001 vs macular region, p < 0.0001 vs peripheral region). Within the macular region, the foveal area exhibited a greater total signal void area in comparison with both the parafoveal area (p < 0.0001) and the perifoveal area (p < 0.0001). In conclusion we report quantitative mapping of the choriocapillaris in myopic eyes compared with an age-matched normal control group. The CC perfusion appears to have a wide topographical variation.
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Affiliation(s)
| | - Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
| | - Enrico Borrelli
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Daniele Libertini
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
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Mastropasqua R, D'Aloisio R, Di Antonio L, Erroi E, Borrelli E, Evangelista F, D'Onofrio G, Di Nicola M, Di Martino G, Toto L. Widefield optical coherence tomography angiography in diabetic retinopathy. Acta Diabetol 2019; 56:1293-1303. [PMID: 31468199 DOI: 10.1007/s00592-019-01410-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 08/19/2019] [Indexed: 11/27/2022]
Abstract
AIMS To evaluate superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris (CC) perfusion in macular and near/mid periphery regions in diabetic patients using widefield swept-source optical coherence tomography angiography (WSS-OCTA). METHODS Ninety-four diabetic patients (94 eyes) classified as diabetics without diabetic retinopathy (no DR) (25 eyes), mild DR (23 eyes), moderate/severe DR (26 eyes), proliferative DR (20 eyes) and a control group of 25 healthy subjects (25 eyes) were imaged with the WSS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). Quantitative analysis was performed in the macular and peripheral regions. The main outcome measures were perfusion density (PD) and vessel length density of SCP, DCP and CC. RESULTS Peripheral retina (all sectors) showed lower SCP and DCP PD compared to the macular region (p < 0.001). In diabetics without DR and DR in different stages, SCP and DCP PD significantly decreased at advancing stages of DR (p < 0.001). At DCP level, central PD was significantly directly related to peripheral PD (superior, R = 0.682 and 0.479; temporal, R = 0.918 and 0.554; inferior, R = 0.711). A good sensitivity and an excellent specificity were found in terms of prediction of disease worsening, especially for central and temporal sectors in all plexuses and for all sectors both central and peripheral of DCP. CONCLUSIONS The widefield OCTA is useful for the study of central and peripheral retina in diabetic patients with or without diabetic retinopathy, assessing good correlation between central and peripheral retina.
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Affiliation(s)
- Rodolfo Mastropasqua
- Vitreoretinal Unit, Bristol Eye Hospital, University of Bristol, Bristol, UK
- Eye Clinic, Polytechnic University of Marche, 60126, Ancona, Italy
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy.
| | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Emanuele Erroi
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Enrico Borrelli
- Department of Ophthalmology, University Vita Salute, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Giada D'Onofrio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, 66100, Chieti, Italy
| | - Giuseppe Di Martino
- Department of Medicine and Science of Ageing, School of Hygiene and Preventive Medicine, University G. d'Annunzio Chieti-Pescara, 66100, Chieti, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
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Mastropasqua R, D’Aloisio R, Viggiano P, Borrelli E, Iafigliola C, Di Nicola M, Aharrh-Gnama A, Di Marzio G, Toto L, Mariotti C, Carpineto P. Early retinal flow changes after vitreoretinal surgery in idiopathic epiretinal membrane using swept source optical coherence tomography angiography. J Clin Med 2019; 8:jcm8122067. [PMID: 31771299 PMCID: PMC6947278 DOI: 10.3390/jcm8122067] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 10/02/2019] [Revised: 11/11/2019] [Accepted: 11/18/2019] [Indexed: 11/16/2022] Open
Abstract
(1) Background: The aim of this observational cross-sectional work was to investigate early retinal vascular changes in patients undergoing idiopathic epiretinal membrane (iERM) surgery using swept source optical coherence tomography angiography (SS-OCTA); (2) Methods: 24 eyes of 24 patients who underwent vitrectomy with internal limiting membrane (ILM) peeling were evaluated pre- and postoperatively using SS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). For each eye, five 6x6-mm OCTA volume scans were acquired by two observers independently. The en face images of superficial capillary plexus (SCP) were then exported to imageJ and a semi-automated algorithm was used for subsequent quantitative analysis. Perfusion density (PD), vessel length density (VLD), vessel diameter index (VDI) and vessel tortuosity (VT) of SCP were evaluated in both the parafoveal (2.5 mm diameter) and perifoveal areas (5.5 mm diameter); (3) Results: At OCTA analysis statistically significant differences were found between controls and diseased eyes for all parameters in parafoveal and perifoveal regions (p < 0.001; p < 0.05) except for perifoveal VLD. During 6-month follow up, both anatomical/perfusion and functional parameters showed a statistically significant improvement if compared to preoperative values. In detail, at one-month post vitrectomy, VLD and VT significantly changed in parafoveal region (p = 0.043; p = 0.045), while PD and VDI showed a trend of increase in both parafoveal and perifoveal region. At 6 months after surgery, PD, VLD and VT of parafoveal region significantly improved (p = 0.021, p = 0.018, p = 0.047 respectively). (4) Conclusions: SS-OCTA provides a quantitative and qualitative analysis of the superficial capillary plexus allowing for early vascular changes assessment after vitrectomy with iERM and ILM peeling.
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Affiliation(s)
- Rodolfo Mastropasqua
- Eye Clinic, Polytechnic University of Marche, 60126 Ancona, Italy; (R.M.)
- Institute of Ophthalmology, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Rossella D’Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (P.V.); (C.I.); (A.A.-G.); (G.D.M.); (L.T.); (P.C.)
- Correspondence:
| | - Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (P.V.); (C.I.); (A.A.-G.); (G.D.M.); (L.T.); (P.C.)
| | - Enrico Borrelli
- Department of Ophthalmology, University Vita Salute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy;
| | - Carla Iafigliola
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (P.V.); (C.I.); (A.A.-G.); (G.D.M.); (L.T.); (P.C.)
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy;
| | - Agbéanda Aharrh-Gnama
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (P.V.); (C.I.); (A.A.-G.); (G.D.M.); (L.T.); (P.C.)
| | - Guido Di Marzio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (P.V.); (C.I.); (A.A.-G.); (G.D.M.); (L.T.); (P.C.)
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (P.V.); (C.I.); (A.A.-G.); (G.D.M.); (L.T.); (P.C.)
| | - Cesare Mariotti
- Eye Clinic, Polytechnic University of Marche, 60126 Ancona, Italy; (R.M.)
| | - Paolo Carpineto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (P.V.); (C.I.); (A.A.-G.); (G.D.M.); (L.T.); (P.C.)
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Iacono P, Toto L, Costanzo E, Varano M, Parravano MC. Pharmacotherapy of Central Serous Chorioretinopathy: A Review of the Current Treatments. Curr Pharm Des 2019; 24:4864-4873. [PMID: 30674250 DOI: 10.2174/1381612825666190123165914] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 12/12/2018] [Accepted: 01/18/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Central serous chorioretinopathy (CSC) is the fourth most frequent retinal disorder in terms of prevalence. It typically occurs in young subjects and affects men more often than women. CSC is characterized by serous retinal detachment (SRD) involving mainly the macular area. The clinical course is usually selflimited, with spontaneous resolution within 3 months. The persistence of SRD or multiple relapse may result in a chronic form of CSC distinguished by permanent retinal pigment epithelium (RPE) and photoreceptor damage. As the pathogenetic mechanism of CSC primarily involves RPE and choroidal vascularization, the current therapeutic approaches aim to restore the normal functions of RPE and normal choroidal vascular permeability. In this review, the authors aim to summarize the current therapeutic approach to CSC. METHODS A comprehensive review of the literature was conducted in PubMed by searching for relevant studies on the current therapeutic options for CSC, including simple observation, conventional laser treatment, subthreshold laser treatment (SLT), photodynamic therapy (PDT) with verteporfin, treatment with mineralocorticoid receptor (MR) antagonists and treatment with anti-vascular endothelial growth factor drugs. RESULTS Since most cases resolve spontaneously, the most common initial CSC treatment is observation. Current evidence suggests that PDT and SLT are valuable in improving visual acuity, reducing subretinal fluid and maintaining long-term effectiveness. No clear evidence of efficacy has been achieved for anti-VEGF. MR antagonists might be a viable choice for the treatment of chronic CSC. CONCLUSION The pathophysiology of CSC remains poorly understood and as a consequence, the gold standard of care for CSC is yet to be defined. To date, PDT and SLT continue to offer good clinical outcomes. Positive preliminary results seem to emerge from the studies of MR antagonists.
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Affiliation(s)
| | - Lisa Toto
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University G. d'Annunzio Chieti-Pescara, Chieti, Italy
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Mastropasqua L, Di Staso S, D'Aloisio R, Mastropasqua A, Di Antonio L, Senatore A, Ciancaglini M, Di Nicola M, Di Martino G, Tognetto D, Toto L. Anatomical and functional changes after dexamethasone implant and ranibizumab in diabetic macular edema: a retrospective cohort study. Int J Ophthalmol 2019; 12:1589-1597. [PMID: 31637195 DOI: 10.18240/ijo.2019.10.11] [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: 08/12/2018] [Accepted: 04/16/2019] [Indexed: 02/08/2023] Open
Abstract
AIM To investigate the efficacy and safety of ranibizumab (RZB group) and dexamethasone implant (DEX group) intravitreal treatments in patients with treatment-naïve center involved diabetic macular edema (DME) by means of functional and morphological assessments. METHODS This retrospective cohort study included 50 eyes of 50 patients with DME treated either with RBZ or DEX. Best-corrected visual acuity (BCVA) and microperimetry were evaluated at baseline and during a 6-month follow-up. In addition, central macular thickness (CMT) by means of structural optical coherence tomography (OCT) and retinal capillary plexus density and choriocapillary density by means of OCT angiography were assessed in all cases. RESULTS Functional and morphological parameters significantly improved during the study period in both groups. BCVA improved significantly in both groups with a greater increase in the DEX group compared to the RBZ group (P=0.030). Microperimetry significantly differed during follow-up between the two treatments (P=0.031). In both groups CMT significantly decreased (P<0.001) without statistically significant differences between the two groups. A statistically significant increase of deep capillary plexus density was detected in both groups at 30d after therapy. The retreatment rate was 0.70±0.10 and 0.65±0.10 in the RBZ group and 0.65±0.10 and 0.50±0.11 in DEX group at 120 and 180d respectively. Two out of 25 patients in DEX group showed intraocular pressure increase requiring hypotonic eye drops. CONCLUSION Both treatments are very effective for DME treatment during 6mo of follow-up with a lower retreatment rate in DEX group.
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Affiliation(s)
- Leonardo Mastropasqua
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University "G. d'Annunzio" Chieti-Pescara, Chieti 66100, Italy
| | - Silvio Di Staso
- Department of Life, Health and Environmental Sciences, Ophthalmology Clinic, University of L'Aquila, L'Aquila 67100, Italy
| | - Rossella D'Aloisio
- Department of Medicine, Surgery and Health Sciences, Eye Clinic, University of Trieste, Trieste 34129, Italy
| | - Alessandra Mastropasqua
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University "G. d'Annunzio" Chieti-Pescara, Chieti 66100, Italy
| | - Luca Di Antonio
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University "G. d'Annunzio" Chieti-Pescara, Chieti 66100, Italy
| | - Alfonso Senatore
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University "G. d'Annunzio" Chieti-Pescara, Chieti 66100, Italy
| | - Marco Ciancaglini
- Department of Life, Health and Environmental Sciences, Ophthalmology Clinic, University of L'Aquila, L'Aquila 67100, Italy
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, Chieti 66100, Italy
| | - Giuseppe Di Martino
- Department of Medicine and Science of Ageing, School of Hygiene and Preventive Medicine, University "G. d'Annunzio" Chieti-Pescara, Chieti 66100, Italy
| | - Daniele Tognetto
- Department of Medicine, Surgery and Health Sciences, Eye Clinic, University of Trieste, Trieste 34129, Italy
| | - Lisa Toto
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University "G. d'Annunzio" Chieti-Pescara, Chieti 66100, Italy
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Mastropasqua R, Senatore A, Di Antonio L, Di Nicola M, Marchioni M, Perna F, Amore F, Borrelli E, De Nicola C, Carpineto P, Toto L. Correlation between Choriocapillaris Density and Retinal Sensitivity in Stargardt Disease. J Clin Med 2019; 8:jcm8091432. [PMID: 31510083 PMCID: PMC6780313 DOI: 10.3390/jcm8091432] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 08/20/2019] [Accepted: 08/27/2019] [Indexed: 02/03/2023] Open
Abstract
The aim of this work was to characterize the choriocapillaris (CC) in patients with Stargardt disease (STGD) using the swept source widefield optical coherence tomography angiography (SS WF OCTA) and to compare CC perfusion density to retinal sensitivity, analyzed using microperimetry (MP). This cross-sectional study included 9 patients (18 eyes) with STGD and central CC atrophy (stage 3 STGD). The CC was analyzed using SS WF OCTA and areas of different CC impairment were quantified and correlated with retinal sensitivity analyzed using MP. The main outcome measures were the percent perfused choriocapillaris area (PPCA), retinal sensitivity, and correlation between PPCA and retinal sensitivity. Seventeen eyes of 9 patients suffering from stage 3 STGD were analyzed. SS WF OCTA revealed a vascular rarefaction in central atrophic zones and a near atrophy halo of choriocapillaris impairment. In all eyes were noticed a central atrophy (CA) area with absolute absence of CC that corresponded to 0 dB points at MP, a near atrophy (NA) zone of PPCA impairment that included points with decreased sensitivity at MP and a distant from atrophy (DA) zone with higher PPCA and retinal sensitivity values. The mean difference of PPCA and retinal sensitivity between NA and CA and DA and CA was statistical significantly different (p < 0.01), the latter showing higher values. A direct relationship between PPCA and retinal sensitivity was found (p < 0.001). Choriocapillaris damage evaluated using SS WF OCTA correlates with MP, these data suggest that CC impairment may be a predictor of retinal function in patients with STGD.
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Affiliation(s)
- Rodolfo Mastropasqua
- Ophthalmology Clinic, University of Marche, 60126 Ancona, Italy
- Vitreoretinal Unit, Bristol Eye Hospital, University of Bristol, Bristol BS8 1TH, UK
| | - Alfonso Senatore
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy.
- Duke Eye Center, Duke University, Durham, NC 27705, USA.
| | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy
| | - Michele Marchioni
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy
| | - Fabiana Perna
- National Center for Services and Research for the Prevention of Blindness and Visual Rehabilitation of the Visually Impaired, 00100 Rome, Italy
| | - Filippo Amore
- National Center for Services and Research for the Prevention of Blindness and Visual Rehabilitation of the Visually Impaired, 00100 Rome, Italy
| | - Enrico Borrelli
- Ophthalmology Department, San Raffaele University Hospital, 20132 Milan, Italy
| | - Chiara De Nicola
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy
| | - Paolo Carpineto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy
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Toto L, Viggiano P, Vecchiarino L, Evangelista F, Borrelli E, Mastropasqua L. Anterior capsule contraction syndrome: a successful multimodal therapeutic approach. Int J Ophthalmol 2019; 12:1356-1358. [PMID: 31456930 DOI: 10.18240/ijo.2019.08.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/23/2019] [Indexed: 11/23/2022] Open
Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti 66100, Italy
| | - Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti 66100, Italy
| | - Luca Vecchiarino
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti 66100, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti 66100, Italy
| | - Enrico Borrelli
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti 66100, Italy
| | - Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti 66100, Italy
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Borrelli E, Uji A, Toto L, Viggiano P, Evangelista F, Mastropasqua R. In Vivo Mapping of the Choriocapillaris in Healthy Eyes: A Widefield Swept-Source OCT Angiography Study. Ophthalmol Retina 2019; 3:979-984. [PMID: 31371198 DOI: 10.1016/j.oret.2019.05.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 05/01/2019] [Accepted: 05/24/2019] [Indexed: 01/18/2023]
Abstract
PURPOSE To report variation of choriocapillaris flow in peripapillary, macular, and near- and mid-periphery regions in healthy participants using widefield swept-source (SS) OCT angiography (OCTA). DESIGN Prospective, cross-sectional study. PARTICIPANTS Fifty healthy participants. METHODS Healthy young participants were imaged with the SS OCTA system (PLEX Elite 9000; Carl Zeiss Meditec, Inc, Dublin, CA). OCT angiography scans were obtained in primary and extreme gazes and a montage was created automatically. The en face choriocapillaris images then were exported to ImageJ software version 1.50 (National Institutes of Health, Bethesda, MD), and a semiautomated algorithm was used for subsequent quantitative analysis. MAIN OUTCOME MEASURES Quantitative analysis of the choriocapillaris performed in 3 different regions: (1) peripapillary, (2) macular, and (3) periphery. In addition, choriocapillaris variables were investigated further in distinct fields within these 3 different regions. RESULTS Fifty eyes (50 participants) were included in the analysis. Mean age ± standard deviation was 25.2±5.1 years (median, 24.5 years; range, 20.0-40.0 years). The peripapillary region exhibited the greatest total signal void area (P < 0.0001 vs. the macular region; P < 0.0001 vs. the peripheral region). Within the macular region, the foveal area exhibited a greater total signal void area in comparison with both the parafoveal area (P = 0.009) and the perifoveal area (P = 0.015). In the analysis investigating the near- and mid-periphery region, the temporal sector was characterized by a lower total signal void area compared with both the superior and inferior areas (P = 0.016 and P = 0.003, respectively). CONCLUSIONS We report quantitative mapping of the choriocapillaris in healthy individuals. Choriocapillaris perfusion seems to have a wide topographic variation.
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Affiliation(s)
- Enrico Borrelli
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
| | - Akihito Uji
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Bristol Eye Hospital, University Hospitals NHS Foundation Trust, Bristol, United Kingdom
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Rozema JJ, Hershko S, Tassignon M, Lorenz K, von Trentini M, Sala Pomares E, Corral MJG, Bataille L, Alió JL, Jongenelen S, Ruiz‐Hidalgo I, Rauscher FG, Blüsch MT, Dawczynski J, Wiedemann P, Mosca L, Guccione L, Riso M, Toro ME, Rosati A, Duch F, Escude R, Martinez A, Morilla‐Grasa A, Peris‐Martínez C, Díez Ajenjo A, Garcia Domene C, De Febrer MB, Solans TT, Gazdik AV, Varssano D, Gold B, Toto L, Mastropasqua A, Mastropasqua L, Fasce F, Spinelli A, Knutsson K, Fogliato G. The components of adult astigmatism and their age‐related changes. Ophthalmic Physiol Opt 2019; 39:183-193. [DOI: 10.1111/opo.12616] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/19/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Jos J Rozema
- Department of Ophthalmology Antwerp University Hospital Edegem Belgium
- Department of Medicine and Health Sciences University of Antwerp Wilrijk Belgium
| | - Sarah Hershko
- Department of Ophthalmology Antwerp University Hospital Edegem Belgium
- Department of Medicine and Health Sciences University of Antwerp Wilrijk Belgium
| | - Marie‐José Tassignon
- Department of Ophthalmology Antwerp University Hospital Edegem Belgium
- Department of Medicine and Health Sciences University of Antwerp Wilrijk Belgium
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49
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Toto L, D'Aloisio R, Mastropasqua R, Di Antonio L, Di Nicola M, Di Martino G, Evangelista F, Erroi E, Doronzo E, Mariotti C. Anatomical and Functional Changes of the Retina and the Choroid after Resolved Chronic CSCR. J Clin Med 2019; 8:jcm8040474. [PMID: 30959979 PMCID: PMC6517936 DOI: 10.3390/jcm8040474] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 03/06/2019] [Revised: 03/28/2019] [Accepted: 04/04/2019] [Indexed: 11/22/2022] Open
Abstract
Background: To investigate anatomical/functional changes after oral eplerenone therapy for chronic central serous chorioretinopathy (CCSC) in successfully treated eyes and fellow eyes and assess timing of foveal subretinal fluid (SRF) resolution. Methods: Twenty-one eyes of 21 patients suffering from CCSC with monolateral foveal SRF successfully treated with oral eplerenone were enrolled in this retrospective study (group 1). The fellow eyes (21 eyes; group 2), healthy or affected by CCSC, without foveal SRF were considered in the analysis. A control healthy group was enrolled as well (healthy controls; n = 21). Main outcome measures during follow-up included changes of best corrected visual acuity (BCVA, logMAR), central macular thickness (CMT; µm), SRF (µm), subfoveal choroidal thickness (SFCT; µm), superficial capillary plexus density (SCPD, %), deep capillary plexus density (DCPD, %), and choriocapillaris density (CCD, %) and percentage of eyes showing foveal SRF resolution at different time points. Results: Functional and anatomical parameters significantly improved during the study in group 1. BCVA increased significantly (p < 0.001), while CMT, SFCT, and SRF decreased significantly (p < 0.001; p < 0.001, and p = 0.037, respectively). SCPD, DCPD, and CCD did not show any statistically significant difference during follow-up. In 71.4% of eyes, resolution of SRF was observed within 60 days and in the remaining 28.6%, at 120 days. In fellow eyes, SFCT decreased significantly (p < 0.001), whilst all other parameters did not modify. Conclusions: Eplerenone treatment in chronic CSCR potentially improves recovery of retinal and choroidal morphology as well as visual acuity gain. A complete resolution of foveal SRF was observed in all eyes during a 4-month follow-up, with most eyes healing at 2 months.
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Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
| | - Rodolfo Mastropasqua
- Vitreoretinal Unit, Bristol Eye Hospital, University of Bristol, Bristol, BS1 4TB, UK.
- Eye Clinic, Polytechnic University of Marche, 60126 Ancona, Italy.
| | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy.
| | - Giuseppe Di Martino
- Department of Medicine and Science of Ageing, School of Hygiene and Preventive Medicine, University G. d'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
| | - Emanuele Erroi
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
| | - Emanuele Doronzo
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
| | - Cesare Mariotti
- Eye Clinic, Polytechnic University of Marche, 60126 Ancona, Italy.
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50
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Mastropasqua R, D'Aloisio R, Di Nicola M, Di Martino G, Lamolinara A, Di Antonio L, Tognetto D, Toto L. Relationship between aqueous humor cytokine level changes and retinal vascular changes after intravitreal aflibercept for diabetic macular edema. Sci Rep 2018; 8:16548. [PMID: 30410092 PMCID: PMC6224583 DOI: 10.1038/s41598-018-35036-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 08/03/2018] [Accepted: 10/26/2018] [Indexed: 12/24/2022] Open
Abstract
The aim of this work was to investigate the changes in aqueous humor cytokine levels after intravitreal injection of aflibercept in diabetic macular edema (DME) and to evaluate the relationship between cytokines modifications and central macular thickness (CMT) and retinal/choroidal vascular changes using structural and functional optical coherence tomography (OCT). Aqueous concentrations of 38 cytokines were measured via multiplex bead assay. In addition, spectral domain OCT and OCT angiography with SSADA software (XR Avanti® AngioVue) were performed at baseline and after intravitreal injections. VEGF, IL-6, IL-5, IL-1β, Eotaxin, GRO, IL-12p40, IL-12p70, IL-1RA, Flt-3L and IP-10 showed a statistically significant decrease through the follow-up (p < 0.05; p < 0.001), while Fraktalkine and GM-CSF significantly increased (p < 0.05). Best corrected visual acuity significantly increased and CMT significantly decreased during follow-up (p < 0.001 and p = 0.013). Superficial capillary plexus and deep capillary plexus density significantly increased (p < 0.001 and p = 0.014). A positive relation was found between GRO, VEGF, Fraktalkine, IP-10, IL-12p70 aqueous humor levels and CMT (p < 0.05; p < 0.001). Aflibercept is a primary anti-VEGF treatment producing a decrease of DME due to the reduction of vascular permeability, nevertheless other inflammatory cytokines showed modification after aflibercept intravitreal injections probably related to edema modification or to an interaction of aflibercept with other inflammatory cytokines.
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Affiliation(s)
- Rodolfo Mastropasqua
- Department of Neuroscience, Polytechnic University of Marche, Ancona, 60126, Italy
| | - Rossella D'Aloisio
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, 34100, Italy.
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, Chieti, 66100, Italy
| | - Giuseppe Di Martino
- School of Hygiene and Preventive Medicine, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara, Chieti, 66100, Italy
| | - Alessia Lamolinara
- Department of Medicine and Aging Science, CeSi-Met, University "G. d'Annunzio" Chieti-Pescara, Chieti, 66100, Italy
| | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara, Chieti, 66100, Italy
| | - Daniele Tognetto
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, 34100, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara, Chieti, 66100, Italy
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