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Finzi A, Valsecchi N, Tassi F, Cellini M, Fontana L. Chronic Central Serous Chorioretinopathy with Pigment Epithelium Detachment Treated with Sildenafil: A Case Report. Case Rep Ophthalmol 2022; 13:692-699. [PMID: 36845460 PMCID: PMC9944586 DOI: 10.1159/000524992] [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: 03/25/2022] [Accepted: 05/09/2022] [Indexed: 11/19/2022] Open
Abstract
Central serous chorioretinopathy (CSCR) is a retinal disease that may be complicated by the development of serous retinal pigment epithelial detachment (PED). The exact molecular mechanisms of CSCR have remained uncertain as well as there is no effective medical therapy. Herein, we describe a case of a 43-year-old male suffering from chronic CSCR with PED and visual acuity reduction (20/40) that showed improvement in visual acuity (20/25) and metamorphopsia 2 weeks after daily intake of 20 mg sildenafil tablets. Optical coherence tomography (OCT) scan showed resolution of PED with residual degeneration of the photoreceptor inner and outer segment layer and retinal pigmented epithelium. The patient continued treatment with sildenafil 20 mg for 2 months. Six months after the discontinuation of therapy, visual acuity was maintained, with absence of PED at OCT. Our case supports the hypothesis that phosphodiesterase type 5 (PDE-5) inhibitors may be an alternative in the treatment of patients with CSCR, alone or combined with other medications.
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Affiliation(s)
- Alessandro Finzi
- aOphthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy,*Alessandro Finzi,
| | - Nicola Valsecchi
- aOphthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Filippo Tassi
- bOphthalmology Unit, Policlinico di Monza, University of Milano Bicocca, Monza, Italy
| | - Mauro Cellini
- aOphthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Luigi Fontana
- aOphthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Cellini M, Finzi A, Corcioni B, Roda M, Gaudiano C, Golfieri R, Schiavi C. ET‐1 plasma levels and scleral rigidity as risk factors in neovascular age‐related macular degeneration. Acta Ophthalmol 2022. [DOI: 10.1111/j.1755-3768.2022.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Mauro Cellini
- Ophthalmology Service Department of Experimental, Diagnostic, and Specialty Medicine University of Bologna Bologna Italy
| | - Alessandro Finzi
- Ophthalmology Service Department of Experimental, Diagnostic, and Specialty Medicine University of Bologna Bologna Italy
| | - Beniamino Corcioni
- Department of Radiology Department of Radiology IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna Italy
| | - Matilde Roda
- Ophthalmology Service Department of Experimental, Diagnostic, and Specialty Medicine University of Bologna Bologna Italy
| | - Caterina Gaudiano
- Department of Radiology Department of Radiology IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna Italy
| | - Rita Golfieri
- Department of Radiology Department of Radiology IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna Italy
| | - Costantino Schiavi
- Ophthalmology Service Department of Experimental, Diagnostic, and Specialty Medicine University of Bologna Bologna Italy
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Cellini M, Tassi F, Finzi A, Roda M, Schiavi C. Pigment epithelium detachment treated with sildenafil: a case report. Acta Ophthalmol 2022. [DOI: 10.1111/j.1755-3768.2022.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Mauro Cellini
- Ophthalmology Service Department of Experimental, Diagnostic, and Specialty Medicine University of Bologna Bologna Italy
| | - Filippo Tassi
- Ophthalmology Service Department of Experimental, Diagnostic, and Specialty Medicine University of Bologna Bologna Italy
| | - Alessandro Finzi
- Ophthalmology Service Department of Experimental, Diagnostic, and Specialty Medicine University of Bologna Bologna Italy
| | - Matilde Roda
- Ophthalmology Service Department of Experimental, Diagnostic, and Specialty Medicine University of Bologna Bologna Italy
| | - Costantino Schiavi
- Ophthalmology Service Department of Experimental, Diagnostic, and Specialty Medicine University of Bologna Bologna Italy
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Cellini M, Rotondi M, Tanda ML, Piantanida E, Chiovato L, Beck-Peccoz P, Lania A, Mazziotti G. Skeletal health in patients with differentiated thyroid carcinoma. J Endocrinol Invest 2021; 44:431-442. [PMID: 32696339 DOI: 10.1007/s40618-020-01359-6] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/09/2020] [Indexed: 02/06/2023]
Abstract
Osteoporosis and fractures are important comorbidities in patients with differentiated thyroid cancer (DTC), with potential negative impact on quality of life and survival. The main determinant of skeletal fragility in DTC is the thyrotropin (TSH)-suppressive therapy, which is commonly recommended to prevent disease's recurrence, especially in patients with structural incomplete response after thyroid surgery and radio-iodine therapy. TSH-suppressive therapy can stimulate bone resorption with consequent bone loss, deterioration of bone microstructure and high risk of fragility fractures. The skeletal effects of TSH-suppressive therapy may be amplified when thyroid cancer cells localize to the skeleton inducing alterations in bone remodelling, impairment of bone structure and further increase in risk of fractures. The management of skeletal fragility in DTC may be challenging, since prediction of fractures is a matter of uncertainty and data on effectiveness and safety of bone-active agents in this clinical setting are still scanty. This review deals with pathophysiological, clinical and therapeutic aspects of skeletal fragility of patients with DTC.
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Affiliation(s)
- M Cellini
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center, IRCCS, via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - M Rotondi
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100, Pavia, Italy
| | - M L Tanda
- Department of Medicine and Surgery, Endocrine Unit, University of Insubria, ASST Dei Sette Laghi, Viale Borri, 57, 21100, Varese, Italy
| | - E Piantanida
- Department of Medicine and Surgery, Endocrine Unit, University of Insubria, ASST Dei Sette Laghi, Viale Borri, 57, 21100, Varese, Italy
| | - L Chiovato
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100, Pavia, Italy
| | - P Beck-Peccoz
- University of Milan, Via Pietro Custodi 16, 20136, Milan, Italy
| | - Andrea Lania
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center, IRCCS, via Manzoni 56, 20089, Rozzano, Milan, Italy.
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4 Pieve Emanuele, 20090, Milan, Italy.
| | - G Mazziotti
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center, IRCCS, via Manzoni 56, 20089, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4 Pieve Emanuele, 20090, Milan, Italy
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Weber C, Cellini M, Lien V, Boeri P, Roussy L, Sceglio P, Ramilo D, Galarco S, Sharry E. S. Avances en tecnologías de propagación y domesticación de plantas de interés económico y ambiental en Argentina. RB 2021. [DOI: 10.21931/rb/2021.06.01.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
En el Laboratorio de Estudios de la Madera de la Facultad de Ciencias Agrarias y Forestales de la Universidad Nacional de La Plata, Argentina, se implementa el proyecto de desarrollo tecnológico denominado Métodos y tecnologías de propagación y domesticación de plantas para el desarrollo de una bioeconomía local basada en la biodiversidad. El objetivo del mismo es desarrollar, optimizar y adaptar nuevas metodologías y tecnologías de propagación y conservación de recursos genéticos vegetales para la producción de plantas en nuevo escenario de la bioeconomía nacional. La diversidad está en la base de la bioeconomía, y muchas veces el material vegetal para plantar para diferentes fines es escaso. Las especies contempladas en éste proyecto son: Quercus sp.; Polylepis tarapacana; Prosopis alpataco, Eranthemun pulchelum y Heteropteris angustifolia Griseb . En este trabajo se comunican algunos de los avances alcanzados aplicando diferentes enfoques para la producción de plantas de calidad (semillas, cultivo de tejidos in vitro, macropropagación y plantines en contenedores)
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Affiliation(s)
- C Weber
- Facultad de Ciencias Agrarias y Forestales, Universidad Nacional de La Plata, Calle 60 s/n, (1900) La Plata, Buenos Aires, Argentina
| | - M Cellini
- Laboratorio de Investigaciones de la Madera (LIMAD)- Facultad de Ciencias Agrarias y Forestales, Universidad Nacional de La Plata, Calle 60 s/n, (1900) La Plata, Buenos Aires, Argentina
| | - V. Lien
- Laboratorio de Investigaciones de la Madera (LIMAD)- Facultad de Ciencias Agrarias y Forestales, Universidad Nacional de La Plata, Calle 60 s/n, (1900) La Plata, Buenos Aires, Argentina
| | - P Boeri
- Unidad Integrada para la Innovación del Sistema Agroalimentario de la Patagonia Norte, UIISA; Centro de Investigación y Transferencia de Río Negro, CIT-RN-CONICET; Universidad Nacional de Río Negro, Belgrano 526, (8500) Viedma, Río Negro, Argentina
| | - L Roussy
- Facultad de Ciencias Agrarias y Forestales, Universidad Nacional de La Plata, Calle 60 s/n, (1900) La Plata, Buenos Aires, Argentina
| | - P. Sceglio
- Facultad de Ciencias Agrarias y Forestales, Universidad Nacional de La Plata, Calle 60 s/n, (1900) La Plata, Buenos Aires, Argentina
| | - D Ramilo
- Facultad de Ciencias Agrarias y Forestales, Universidad Nacional de La Plata, Calle 60 s/n, (1900) La Plata, Buenos Aires, Argentina
| | - S Galarco
- Investigador. Laboratorio de Investigaciones de la Madera (LIMAD)- Facultad de Ciencias Agrarias y Forestales, Universidad Nacional de La Plata, Calle 60 s/n, (1900) La Plata, Buenos Aires, Argentina
| | - Sandra Sharry E.
- Universidad Nacional de Río Negro, Belgrano 526, (8500) Viedma, Río Negro, Argentina
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Cellini M, Piccini S, Ferrante G, Carrone F, Olivetti R, Cicorella N, Aroldi M, Pini D, Centanni M, Lania AG, Mazziotti G. Secondary hyperparathyroidism and thoracic vertebral fractures in heart failure middle-aged patients: a 3-year prospective study. J Endocrinol Invest 2020; 43:1561-1569. [PMID: 32240522 DOI: 10.1007/s40618-020-01237-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 03/23/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE Vertebral fractures (VFs) were described in elderly patients with heart failure (HF) whereas their prevalence and determinants in younger HF patients are still unknown. This study aimed at assessing whether secondary hyperparathyroidism (SHPT) may influence the risk of VFs in middle-aged patients with HF. METHODS 84 patients (44 males, median age 48.5 years, range 43-65) with HF were prospectively evaluated at the baseline and after 36-month follow-up for bone mineral density (BMD) and VFs by quantitative morphometry on chest X-rays. Serum PTH, calcium, 25-hydroxyvitamin D and 24-h-urinary calcium were evaluated at the baseline and every 6-12 months during the study period. RESULTS At baseline, SHPT, hypovitaminosis D and VFs were found in 43 patients (51.2%), 73 patients (86.9%) and 29 patients (34.5%), respectively. SHPT was associated with VFs at baseline [inverse probability-weighted (ipw) odds ratio (OR) 12.2, p < 0.001]. Patients were treated with vitamin D3 alone (56%), vitamin D3 plus calcium carbonate (21.4%), calcitriol alone (4.8%), bisphosphonates plus vitamin D3 (8.3%) or a combination of bisphosphonates, vitamin D3 and calcium carbonate (9.5%). At the end of follow-up, hypovitaminosis D was corrected in all patients, whereas 19/84 patients (22.6%) had persistent SHPT. During the follow-up, 16 patients developed incident VFs which resulted to be associated with baseline SHPT (ipw OR 55.7, p < 0.001), even after adjusting from BMD change from baseline to follow-up (ipw OR 46.4, p < 0.001). CONCLUSIONS This study provides a first evidence that SHPT may be a risk factor for VFs in middle-aged patients with HF.
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Affiliation(s)
- M Cellini
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy
- Department of Medical-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Latina, Italy
| | - S Piccini
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy
| | - G Ferrante
- Department of Cardiovascular Medicine, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy
| | - F Carrone
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy
| | - R Olivetti
- Endocrinology Unit, ASST Carlo Poma, Mantova, Italy
| | - N Cicorella
- Cardiology Unit, ASST Carlo Poma, Mantova, Italy
| | - M Aroldi
- Cardiology Unit, ASST Carlo Poma, Mantova, Italy
| | - D Pini
- Department of Cardiovascular Medicine, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy
| | - M Centanni
- Department of Medical-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Latina, Italy
| | - A G Lania
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy.
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.
| | - G Mazziotti
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Schiavi C, Finzi A, Cellini M. Steady-State Pattern Electroretinogram and Frequency Doubling Technology in Adult Dyslexic Readers. Clin Ophthalmol 2019; 13:2451-2459. [PMID: 31849443 PMCID: PMC6912011 DOI: 10.2147/opth.s229898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 11/27/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose Dyslexia is a reading disorder with neurological deficit of the magnocellular pathway. The aim of our study was to evaluate the functionality of the magnocellular-Y (M-Y) retinal ganglion cells in adult dyslexic subjects using steady-state pattern electroretinogram and frequency doubling perimetry. Methods Ten patients with dyslexia (7 females and 3 males), mean age 28.7 ± 5.9 years, and 10 subjects without dyslexia (6 females and 4 males), mean age 27.8 ± 4.1 years, were enrolled in the study and underwent both steady-state pattern-electroretinogram examination and frequency doubling perimetry. Results There was a significant difference in the amplitude of the steady-state pattern electroretinogram of the dyslexic group and the healthy controls (0.610±0.110 μV vs 1.250±0.296 μV; p=0.0001). Furthermore, in the dyslexic group we found a significant difference between the right eye and the left eye (0.671±0.11 μV vs 0.559±0.15 μV; p=0.001). With frequency doubling perimetry, the pattern standard deviation index increased in dyslexic eyes compared to healthy controls (4.40±0.81 dB vs 2.99±0.35 dB; p=0.0001) and in the left eye versus the right eye of the dyslexic group (4.43±1.10 dB vs 3.66±0.96 dB; p=0.031). There was a correlation between the reduction in the wave amplitude of the pattern electroretinogram and the simultaneous increase in the pattern standard deviation values (r=0.80; p=0.001). This correlation was also found to be present in the left eye (r=0.93; p<0.001) and the right eye (r=0.81; p=0.005) of dyslexic subjects. Conclusion Our study shows that there was an alteration of the activity of M-Y retinal ganglion cells, especially in the left eye. It confirms that in dyslexia there is a deficit of visual attention with damage not only of the magnocellular-dorsal pathway but also of the M-Y retinal ganglion cells.
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Affiliation(s)
- Costantino Schiavi
- Department of Experimental, Diagnostic, and Specialty Medicine, Ophthalmology Service, University of Bologna, Bologna 40138, Italy
| | - Alessandro Finzi
- Department of Experimental, Diagnostic, and Specialty Medicine, Ophthalmology Service, University of Bologna, Bologna 40138, Italy
| | - Mauro Cellini
- Department of Experimental, Diagnostic, and Specialty Medicine, Ophthalmology Service, University of Bologna, Bologna 40138, Italy
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Mandese V, Bigi E, Bruzzi P, Palazzi G, Predieri B, Lucaccioni L, Cellini M, Iughetti L. Endocrine and metabolic complications in children and adolescents with Sickle Cell Disease: an Italian cohort study. BMC Pediatr 2019; 19:56. [PMID: 30744584 PMCID: PMC6371531 DOI: 10.1186/s12887-019-1423-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 01/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children with Sickle Cell Disease (SCD) show endocrine complications and metabolic alterations. The physiopathology of these conditions is not completely understood: iron overload due to chronic transfusions, ischemic damage, and inflammatory state related to vaso-occlusive crises may be involved. Aims of this study were to evaluate the growth pattern, endocrine complications, and metabolic alterations and to detect the relationship between these conditions and the SCD severity in affected children and adolescents. METHODS Fifty-two children and adolescents with SCD [38 homozygous sickle hemoglobin (HbSS) and 14 heterozygous sickle hemoglobin (HbSC); age range 3-18 years] were recruited. Anthropometric [height, body mass index (BMI), arm span, sitting height, target height (TH), and pubertal status] and laboratory [blood cell counts, hemolysis indices, metabolic and nutritional status indices and hormonal blood levels] data were evaluated. The SCD severity was defined according to hematological and clinical parameters. RESULTS Height-SDS adjusted for TH and BMI-SDS were significantly higher in HbSC children than in HbSS ones. Forty-eight out of 52 patients (92%) had at least one metabolic and/or endocrine alteration: insufficiency/deficiency of vitamin D (84.7%), insulin resistance (11.5%), growth hormone deficiency (3.8%), subclinical hypothyroidism (3.8%), and hypogonadism (1.9%). Levels of vitamin D were significantly and negatively correlated with clinical indicators of the SCD severity. Subjects with HbSS genotype show significant lower levels of both insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein 3 than children with HbSC. In the study population IGF-1 values were significantly and positively correlated with Hb and negatively with lactate dehydrogenase. CONCLUSIONS Metabolic alterations and endocrine complications are very common in children and adolescents with SCD. A regular follow-up is necessary to identify subjects at risk for complications to precociously start an appropriate treatment and to improve the quality of life of SCD patients.
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Affiliation(s)
- V Mandese
- Post Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy
| | - E Bigi
- Oncology and Hematology Pediatric Unit Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - P Bruzzi
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - G Palazzi
- Oncology and Hematology Pediatric Unit Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - B Predieri
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - L Lucaccioni
- Post Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy
| | - M Cellini
- Oncology and Hematology Pediatric Unit Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - L Iughetti
- Post Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy. .,Oncology and Hematology Pediatric Unit Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124, Modena, Italy. .,Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124, Modena, Italy.
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Candoni A, Klimko N, Busca A, Di Blasi R, Shadrivova O, Cesaro S, Zannier ME, Verga L, Forghieri F, Calore E, Nadali G, Simonetti E, Muggeo P, Quinto AM, Castagnola C, Cellini M, Del Principe MI, Fracchiolla N, Melillo L, Piedimonte M, Zama D, Farina F, Giusti D, Mosna F, Capelli D, Delia M, Picardi M, Decembrino N, Perruccio K, Vallero S, Aversa F, Fanin R, Pagano L. Fungal infections of the central nervous system and paranasal sinuses in onco-haematologic patients. Epidemiological study reporting the diagnostic-therapeutic approach and outcome in 89 cases. Mycoses 2019; 62:252-260. [PMID: 30565742 DOI: 10.1111/myc.12884] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [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: 09/17/2018] [Revised: 11/08/2018] [Accepted: 12/09/2018] [Indexed: 02/02/2023]
Abstract
Invasive fungal infections (IFI) of the Central Nervous System (IFI-CNS) and Paranasal Sinuses (IFI-PS) are rare, life-threatening infections in haematologic patients, and their management remains a challenge despite the availability of new diagnostic techniques and novel antifungal agents. In addition, analyses of large cohorts of patients focusing on these rare IFI are still lacking. Between January 2010 and December 2016, 89 consecutive cases of Proven (53) or Probable (36) IFI-CNS (71/89) and IFI-PS (18/89) were collected in 34 haematological centres. The median age was 40 years (range 5-79); acute leukaemia was the most common underlying disease (69%) and 29% of cases received a previous allogeneic stem cell transplant. Aspergillus spp. were the most common pathogens (69%), followed by mucormycetes (22%), Cryptococcus spp. (4%) and Fusarium spp. (2%). The lung was the primary focus of fungal infection (48% of cases). The nervous system biopsy was performed in 10% of IFI-CNS, and a sinus biopsy was performed in 56% of IFI-PS (P = 0.03). The Galactomannan test on cerebrospinal fluid has been performed in 42% of IFI-CNS (30/71), and it was positive in 67%. Eighty-four pts received a first-line antifungal therapy with Amphotericine B in 58% of cases, Voriconazole in 31% and both in 11%. Moreover, 58% of patients received 2 or more lines of therapy and 38% were treated with a combination of 2 or more antifungal drugs. The median duration of antifungal therapy was 60 days (range 5-835). A surgical intervention was performed in 26% of cases but only 10% of IFI-CNS underwent neurosurgical intervention. The overall response rate to antifungal therapy (complete or partial response) was 57%, and 1-year overall survival was 32% without significant differences between IFI-CNS and IFI-PS. The overall mortality was 69% but the IFI attributable mortality was 33%. Mortality of IFI-CNS/PS remains high but, compared to previous historical data, it seems to be reduced probably due to the availability of newer antifungal drugs. The results arising from this large contemporary cohort of cases may allow a more effective diagnostic and therapeutic management of these very rare IFI complications in haematologic patients.
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Affiliation(s)
- A Candoni
- Clinica Ematologica, ASUI, Udine, Italy
| | - N Klimko
- Metchnikov North-Western State Medical University, St. Petersburg, Russia
| | - A Busca
- S.C. Ematologia, AO Città della Salute e della Scienza, Torino, Italy
| | - R Di Blasi
- Istituto di Ematologia, Polo Onco-Ematologico Fondazione Policlinico A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - O Shadrivova
- Metchnikov North-Western State Medical University, St. Petersburg, Russia
| | - S Cesaro
- Oncoematologia Pediatrica, AOUI, Verona, Italy
| | | | - L Verga
- Clinica Ematologica, Ospedale S Geraldo, Monza, Italy
| | - F Forghieri
- Clinica Ematologica, Dipartimento di Scienze Mediche-Chirurgiche, Università di Modena, Modena, Italy
| | - E Calore
- Clinica di Oncoematologia pediatrica, Dipartimento di Salute della Donna e del Bambino, Azienda Ospedaliero-Universitaria, Padova, Italy
| | - G Nadali
- U.O.C. Ematologia, AOUI, Policlinico GB Rossi, Verona, Italy
| | - E Simonetti
- Ematologia, Ospedale SM Misericordia, Perugia, Italy
| | - P Muggeo
- Oncoematologia Pediatrica, AOUC Policlinico, Bari, Italy
| | - A M Quinto
- UO di Ematologia, Dipartimento di Medicina, AO di Padova, Padova, Italy
| | - C Castagnola
- Dipartimento Oncoematologico Fondazione, ICRRS Policlinico San Matteo, Pavia, Italy
| | - M Cellini
- UO Pediatria, Dipartimento Materno-Infantile, AOU Policlinico, Modena, Italy
| | - M I Del Principe
- Ematologia, Dipartimento di Biomedicina e Prevenzione, Università Tor Vergata, Roma, Italy
| | - N Fracchiolla
- UO Oncoematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - L Melillo
- Divisione di Ematologia, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - M Piedimonte
- Dipartimento di Clinica e di Medicina Molecolare, AOU Sant'Andrea, Università Sapienza, Roma, Italy
| | - D Zama
- Oncoematologia Pediatrica, Ospedale Sant Orsola Malpighi, Bologna, Italy
| | - F Farina
- Clinica Ematologica, Ospedale S Geraldo, Monza, Italy
| | - D Giusti
- Clinica Ematologica, Dipartimento di Scienze Mediche-Chirurgiche, Università di Modena, Modena, Italy
| | - F Mosna
- Struttura Complessa Ematologia, Ospedale Ca' Foncello, Treviso, Italy
| | - D Capelli
- Clinica Ematologica, Ospedali Riuniti di Ancona, Ancona, Italy
| | - M Delia
- Sezione di Ematologia, Università degli studi di Bari, Bari, Italy
| | - M Picardi
- Dipartimento di Scienze Biomediche Avanzate, Università Federico II, Napoli, Italy
| | - N Decembrino
- Oncoematologia Pediatrica, Fondazione IRCCS, Policlinico San Matteo, Pavia, Italy
| | - K Perruccio
- Oncoematologia Pediatrica, Ospedale SM Misericordia, Perugia, Italy
| | - S Vallero
- Ematologia Pediatrica, Ospedale Infantile Regina Margherita S. Anna, Torino, Italy
| | - F Aversa
- Ematologia e Centro Trapianti Midollo Osseo, Università di Parma, Parma, Italy
| | - R Fanin
- Clinica Ematologica, ASUI, Udine, Italy
| | - L Pagano
- Istituto di Ematologia, Polo Onco-Ematologico Fondazione Policlinico A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
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Abstract
The authors evaluated the efficacy of interferon-alpha used intralesionally in the therapy of low-grade conjunctival non-Hodgkin lymphoma in an HIV-positive patient. The patient received one intralesional injection of 1,000,000 U of interferon-alpha three times a week for a total of twelve doses. The remission of conjunctival involvement was seen three months from the end of therapy. The intralesional use of interferon-alpha can be considered an efficacious therapy for low-grade conjunctival non-Hodgkin lymphoma.
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Affiliation(s)
- M Cellini
- Institute of Ophthalmology, University of Bologna, Italy
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Cellini M, Howe J, Kim K. Abstract No. 669 A comparison of particle embolization versus alcohol ablation for the treatment of renal angiomyolipoma: a single-center retrospective review. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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12
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Gizzi C, Cellini M, Campos EC. In vivo assessment of changes in corneal hysteresis and lamina cribrosa position during acute intraocular pressure elevation in eyes with markedly asymmetrical glaucoma. Clin Ophthalmol 2018; 12:481-492. [PMID: 29588569 PMCID: PMC5858548 DOI: 10.2147/opth.s151532] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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] [Indexed: 02/05/2023] Open
Abstract
Purpose To investigate the biomechanical response of the cornea, lamina cribrosa (LC), and prelaminar tissue (PT) to an acute intraocular pressure (IOP) increase in patients with markedly asymmetrical glaucoma and in healthy controls. Patients and methods A total of 24 eyes of 12 patients with markedly asymmetrical primary open-angle glaucoma (POAG) and 12 eyes of 12 healthy patients were examined with spectral-domain optical coherence tomography (SD-OCT) and ocular response analyzer (ORA) at baseline and during acute IOP elevation by means of an ophthalmodynamometer. The displacement of the LC and PT and the change in corneal hysteresis (CH) and corneal resistance factor (CRF) were evaluated. Results Following a mean IOP increase of 12.3±2.4 mmHg, eyes with severe glaucoma demonstrated an overall mean anterior displacement of the LC (−6.58±26.09 µm) as opposed to the posterior laminar displacement in eyes with mild glaucoma (29.08±19.28 µm) and in healthy eyes (30.3±10.9; p≤0.001 and p=0.001, respectively). The PT displaced posteriorly during IOP elevation in all eyes. The CH decreased in eyes with severe glaucoma during IOP elevation (from 9.30±3.65 to 6.92±3.04 mmHg; p=0.012), whereas the CRF increased markedly in eyes with mild glaucoma (from 8.61±2.30 to 12.38±3.64; p=0.002) and in eyes with severe glaucoma (from 9.02±1.48 to 15.20±2.06; p=0.002). The increase in CRF correlated with the anterior displacement of the LC in eyes with severe glaucoma. Conclusion Eyes with severe glaucoma exhibited a mean overall anterior displacement of the anterior laminar surface, while eyes with mild glaucoma and healthy eyes showed a posterior displacement of the LC during IOP elevation. The CH decreased significantly from baseline only in eyes with severe glaucoma, but the CRF increased significantly in all glaucomatous eyes. The CRF increase correlated with the anterior displacement of the LC in eyes with severe glaucoma.
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Affiliation(s)
- Corrado Gizzi
- Department of Experimental, Diagnostic and Speciality Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Mauro Cellini
- Department of Experimental, Diagnostic and Speciality Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Emilio C Campos
- Department of Experimental, Diagnostic and Speciality Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
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Versura P, Bernabini B, Torreggiani A, Cellini M, Caramazza R. Frequent Replacement and Conventional Daily Wear Soft Contact Lens Symptomatic Patients: Tear Film and Ocular Surface Changes. Int J Artif Organs 2018. [DOI: 10.1177/039139880002300906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We analyzed tear film changes, ocular surface tissue alterations and inflammatory conditions in Frequent Replacement Soft (FRS) Contact Lens (CL) or Conventional Soft (CS)-CL wearers suffering from eye discomfort, by applying complementary diagnostic tests. Our data suggest the following conclusions: i) eye discomfort symptoms begin after 1–3 years of successful wear, mainly in FRS-CL wearers; ii) tear film stability is affected by CL wear, mainly in FRS-CL wearers; iii) CL wear produces a subclinical moderate inflammation based on mononuclear cell recruitment in 3 out of 4 patients of both types of lenses; iv) CL wear induces dry eye conditions, more pronounced in FRS-CL users; v) discomfort symptoms, presence of subclinical inflammation, degree of dryness are not directly related to a clinical presentation of intolerance, mainly in FRS-CL wearers; vi) CL wear-related discomfort symptoms should never be underestimated, since a hidden inflammation or dryness can be present beyond an apparently good clinical picture.
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Affiliation(s)
- P. Versura
- Center of Biotechnological and Clinical Research in Ophthalmology, University of Bologna - Italy
| | - B. Bernabini
- Center of Biotechnological and Clinical Research in Ophthalmology, University of Bologna - Italy
| | - A. Torreggiani
- Center of Biotechnological and Clinical Research in Ophthalmology, University of Bologna - Italy
| | - M. Cellini
- Center of Biotechnological and Clinical Research in Ophthalmology, University of Bologna - Italy
| | - R. Caramazza
- Center of Biotechnological and Clinical Research in Ophthalmology, University of Bologna - Italy
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Cellini M, Sebastiani S, Campos E. Acute macular neuroretinopathy type 2: an unusual case. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0f045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M. Cellini
- Department of Specialized- Diagnostic and Experimental Medicine- Ophthalmology S, Department of Specialized- Diagnostic and Experimental Medicine; Bologna Italy
| | - S. Sebastiani
- Department of Specialized- Diagnostic and Experimental Medicine- Ophthalmology S, Department of Specialized- Diagnostic and Experimental Medicine; Bologna Italy
| | - E. Campos
- Department of Specialized- Diagnostic and Experimental Medicine- Ophthalmology S, Department of Specialized- Diagnostic and Experimental Medicine; Bologna Italy
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Sebastiani S, Corcioni B, Pazzaglia A, Gaudiano C, Cellini M, Golfieri R, Campos E. Effect of intravitreal bevacizumab and aflibercept on retrobulbar blood flow in injected and uninjected sound eyes of patients with neovascular age-related macular degeneration. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0f077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S. Sebastiani
- Department of Experimental- Diagnostic and Specialty Medicine - Sant'Orsola; Ophthalmology Unit; Malpighi University Hospital; DIMES; Bologna Italy
| | - B. Corcioni
- Department of Diagnostic and Prevention Medicine; Radiology Service; Bologna Italy
| | - A. Pazzaglia
- Department of Experimental- Diagnostic and Specialty Medicine - Sant'Orsola; Ophthalmology Unit; Malpighi University Hospital; DIMES; Bologna Italy
| | - C. Gaudiano
- Department of Diagnostic and Prevention Medicine; Radiology Service; Bologna Italy
| | - M. Cellini
- Department of Experimental- Diagnostic and Specialty Medicine - Sant'Orsola; Ophthalmology Unit; Malpighi University Hospital; DIMES; Bologna Italy
| | - R. Golfieri
- Department of Diagnostic and Prevention Medicine; Radiology Service; Bologna Italy
| | - E.C. Campos
- Department of Experimental- Diagnostic and Specialty Medicine - Sant'Orsola; Ophthalmology Unit; Malpighi University Hospital; DIMES; Bologna Italy
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Sebastiani S, Fresina M, Cellini M, Campos EC. Hydroxychloroquine for treatment of rheumatoid arthritis: multifocal electroretinogram and laser flare-cell photometry study. Clin Ophthalmol 2017; 11:689-696. [PMID: 28442886 PMCID: PMC5396934 DOI: 10.2147/opth.s130899] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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] [Indexed: 01/22/2023] Open
Abstract
Purpose To evaluate early changes in multifocal electroretinogram (mfERG) and subclinical aqueous humor flare and cellularity in patients receiving hydroxychloroquine (HCQ) as treatment for rheumatoid arthritis. Methods Ten patients receiving treatment with HCQ and no ophthalmic symptoms were enrolled. After complete ocular examination, mfERG and laser flare-cell photometry were performed. Patients were also divided into two subgroups with HCQ cumulative dose (CD) higher or lower than 500 g. Results obtained were compared with a control group of ten healthy subjects and statistical analysis was performed. Results In patients receiving HCQ treatment, mfERG P1-wave in ring 2 showed a significant reduction in amplitude and a significant increase in latency compared to healthy control subjects, respectively resulting in 1.143 μV vs 1.316 μV (P=0.040) and 38.611 ms vs 36.334 ms (P=0.024). These changes are highly related to CD. Furthermore, when using the laser flare-cell photometry, a significant increase in aqueous humor flare and cellularity was shown in patients with CD higher than 500 g, resulting in a mean value of 14.4 ph/ms compared to 8.1 ph/ms in patients with CD lower than 500 g (P=0.0029). These reports appear highly related to CD (P=0.001). Receiver operating characteristic curve analysis showed mfERG P1-wave amplitude in ring 2 as the most sensitive value in detecting early HCQ-related retinopathy. Conclusion MfERG was shown to be a very sensitive test in detecting early retinal toxicity and should be used for the screening of patients receiving HCQ treatment. Although less sensitive, laser flare-cell photometry can provide further information to evaluate early toxic retinal cell damage.
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Affiliation(s)
- Stefano Sebastiani
- Department of Experimental, Diagnostic, and Specialty Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Michela Fresina
- Department of Experimental, Diagnostic, and Specialty Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Mauro Cellini
- Department of Experimental, Diagnostic, and Specialty Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Emilio C Campos
- Department of Experimental, Diagnostic, and Specialty Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
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Brusca N, Virili C, Cellini M, Capriello S, Gargano L, Salvatori R, Centanni M, Santaguida MG. Early detection of biochemically occult autonomous thyroid nodules. Eur J Endocrinol 2016; 175:615-622. [PMID: 27647872 DOI: 10.1530/eje-16-0568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 09/09/2016] [Accepted: 09/19/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Autonomously functioning thyroid areas may be associated with subclinical or overt hyperthyroidism, but may exist even in the presence of normal TSH. This study was aimed at comparing the rate of autonomously functioning areas and their cardiac sequelae in patients with nodular goitre studied with the usual and a novel approach. DESIGN AND METHODS In total 490 adult outpatients with thyroid nodular goitre, living in a mild iodine-deficient area, were selected in our referral centre for thyroid diseases from 2009 to 2014 on the basis of a suspicion of thyroid functional autonomy. They were divided in three groups according to a non-conventional approach (excessive response to thyroxine treatment: group 1) or conventional approach (low/normal TSH with clinical suspicion or low TSH: groups 2 and 3). All patients of the study with the suspicion of thyroid functional autonomy underwent thyroid scan with radioactive iodine (I131) uptake (RAIU). RESULTS The percentage of confirmed thyroid functional autonomy was 319/490, being significantly higher in group 3 than in groups 1 and 2 (81.5 vs 64.7 vs 52.6%; chi-square P < 0.0001). However, the diagnosis with non-conventional approach was made at a significant earlier age (P < 0.0001). Cardiac arrhythmias as well as atrial fibrillation were similarly detected by conventional and non-conventional approaches (chi-square test: P = 0.2537; P = 0.8425). CONCLUSIONS The hyper-responsiveness to thyroxine treatment should induce the suspicion of thyroid functional autonomy at an early stage, allowing to detect autonomous functioning areas in apparently euthyroid patients.
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Affiliation(s)
- N Brusca
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Latina, Italy
| | - C Virili
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Latina, Italy
| | - M Cellini
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Latina, Italy
| | - S Capriello
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Latina, Italy
| | - L Gargano
- Endocrinology UnitAUSL Latina, Latina, Italy
| | - R Salvatori
- Department of Nuclear MedicineAUSL Latina, Latina, Italy
| | - M Centanni
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Latina, Italy
- Endocrinology UnitAUSL Latina, Latina, Italy
| | - M G Santaguida
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Latina, Italy
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Schiavi C, Tassi F, Finzi A, Strobbe E, Cellini M. Steady-state pattern electroretinogram and frequency doubling technology in anisometropic amblyopia. Clin Ophthalmol 2016; 10:2061-2068. [PMID: 27799733 PMCID: PMC5077269 DOI: 10.2147/opth.s117803] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Steady-state pattern electroretinogram (PERG) and frequency doubling technology (FDT) perimetry can be used to selectively investigate the activity of the M-Y ganglion cells in adult anisometropic amblyopes. Methods Fifteen normal subjects (mean 27.8±4.1 years) and 15 adults with anisometropic amblyopia (mean 28.7±5.9 years) were analyzed using steady-state PERG and FDT. Results The amplitude of steady-state PERG was significantly different not only among the control group and both the amblyopic eye (P=0.0001) and the sound eye group (P=0.0001), but also between the latter two groups (P=0.006). The difference in FDT mean deviation was statistically significant not only between the control group and amblyopic eye group (P=0.0002), but also between the control group and the sound eye group (P=0.0009). The FDT pattern standard deviation was significantly higher in the control group rather than in the amblyopic eye (P=0.0001) or the sound eye group (P=0.0001). A correlation was found between the reduction in PERG amplitude and the increase in FDT-pattern standard deviation index not only in amblyopic (P=0.0025) and sound (P=0.0023) eyes, but also in the healthy control group (P=0.0001). Conclusion These data demonstrate that in anisometropic amblyopia, there is an abnormal functionality of a subgroup of the magnocellular ganglion cells (M-Y), and the involvement of these cells, together with the parvocellular pathway, may play a key role in the clinical expression of the disease.
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Affiliation(s)
- Costantino Schiavi
- Department of Experimental, Diagnostic, and Specialty Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Filippo Tassi
- Department of Experimental, Diagnostic, and Specialty Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Alessandro Finzi
- Department of Experimental, Diagnostic, and Specialty Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Ernesto Strobbe
- Department of Experimental, Diagnostic, and Specialty Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Mauro Cellini
- Department of Experimental, Diagnostic, and Specialty Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
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Cellini M, Sebastiani S, Campos E. Early hydroxychloroquine retinal toxicity enhanced by multifocal electroretinogram and laser flare-cell meter. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gigliotti AR, De Ioris MA, De Grandis E, Podda M, Cellini M, Sorrentino S, De Bernardi B, Paladini D, Gandolfo C. Congenital neuroblastoma with symptoms of epidural compression at birth. Pediatr Hematol Oncol 2016; 33:94-101. [PMID: 26901768 DOI: 10.3109/08880018.2015.1135364] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The occurrence of congenital neuroblastoma presenting at birth with symptoms of epidural compression secondary to spinal canal invasion is rare. Almost all cases reported in the literature have survived from the tumor but suffer severe sequelae, with the exception of the 2 most recently described whose birth was anticipated. The 3 cases of this article have been followed for a minimum of 5 years with the aim to describe their definitive late complications. In none of these cases had the routine ultrasound scan performed in third trimester of pregnancy discovered a tumor mass, nor had it shown abnormal fetal movements. All had leg hypotonia detected on the first day of life. In all, both primary and intraspinal tumors responded well to chemotherapy. All survive with motor deficit and severe bladder dysfunction despite early physiotherapy. Scoliosis has developed in the case with the longest follow-up. The description of these patients enforces the importance of early diagnosis of tumor masses in late pregnancy. Neonatologists should be aware of this rare clinical entity and take it into account in the differential diagnosis with other conditions of early-onset hypotonia. On the other hand, obstetric sonologists should be aware of the possibility to detect such rare tumors in late pregnancy, as anticipation of delivery may reduce the risk of late sequelae.
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Affiliation(s)
- A R Gigliotti
- a Epidemiology, Biostatistics and Committees Unit, Istituto Giannina Gaslini , Genoa , Italy
| | - M A De Ioris
- b Department of Hematology-Oncology , Bambino Gesù Children's Hospital , Rome , Italy
| | - E De Grandis
- c Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children's Sciences , University of Genoa , Genoa , Italy
| | - M Podda
- d Department of Pediatric Oncology , Istituto Nazionale Tumori , Milan , Italy
| | - M Cellini
- e Hematology-Oncology Unit, Department of Pediatrics, University of Modena and Reggio Emilia , Modena , Italy
| | - S Sorrentino
- f Department of Hematology-Oncology , Istituto Giannina Gaslini , Genoa , Italy
| | - B De Bernardi
- f Department of Hematology-Oncology , Istituto Giannina Gaslini , Genoa , Italy
| | - D Paladini
- g Fetal Medicine and Therapy Unit, Istituto Giannina Gaslini , Genoa , Italy
| | - C Gandolfo
- h Pediatric Interventional Radiology and Neuroradiology Unit, Istituto Giannina Gaslini , Genoa , Italy
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Cellini M, Gizzi C, Finzi A, Campos E. Biomechanical properties of eyes with asymmetrical glaucoma defect. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.1296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Cellini
- Ophthalmology Service; Department of Specialized- Diagnostic and Experimental Medicine; Bologna Italy
| | - C. Gizzi
- Ophthalmology Service; Department of Specialized- Diagnostic and Experimental Medicine; Bologna Italy
| | - A. Finzi
- Ophthalmology Service; Department of Specialized- Diagnostic and Experimental Medicine; Bologna Italy
| | - E.C. Campos
- Ophthalmology Service; Department of Specialized- Diagnostic and Experimental Medicine; Bologna Italy
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22
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Cellini M, Gizzi C, Finzi A, Campos E. Biomechanical properties of eyes with asymmetrical glaucoma defect. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M. Cellini
- Ophthalmology Service; Department of Specialized, Diagnostic and Experimental Medicine; Bologna Italy
| | - C. Gizzi
- Ophthalmology Service; Department of Specialized, Diagnostic and Experimental Medicine; Bologna Italy
| | - A. Finzi
- Ophthalmology Service; Department of Specialized, Diagnostic and Experimental Medicine; Bologna Italy
| | - E.C. Campos
- Ophthalmology Service; Department of Specialized, Diagnostic and Experimental Medicine; Bologna Italy
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Del Duca SC, Santaguida MG, Brusca N, Gatto I, Cellini M, Gargano L, Verga Falzacappa C, Frattaroli FM, Virili C, Centanni M. Individually-tailored thyroxine requirement in the same patients before and after thyroidectomy: a longitudinal study. Eur J Endocrinol 2015; 173:351-7. [PMID: 26092761 DOI: 10.1530/eje-15-0314] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 06/15/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Thyroxine (T4) requirement after total thyroidectomy for differentiated thyroid carcinoma (DTC) is a debated issue. As most of the studies in the area have been retrospective and/or performed with heterogeneous therapeutic approaches, we designed our study to determine T4 requirement in the same patients and treatment settings, before and after total thyroidectomy. DESIGN, PATIENTS AND METHODS This was a longitudinal study including 23 goitrous patients treated with T4 in an individually tailored fashion. All patients exhibited a stable TSH (median TSH = 0.28 mU/l) at a stable T4 dose for at least 1 year before surgery (median T4 dose = 1.50 μg/kg per day). The patients underwent total thyroidectomy based on cancer suspicion or compressive symptoms. Eventually diagnosed as having DTC (pT1b-pT2N0) and following surgical and radiometabolic treatment, they were treated with the same pre-surgical doses of T4. RESULTS Three months after surgery,using the same pre-surgical dose, median TSH increased up to 5.38 mU/l (P<0.0001) and so the T4 dose had to be increased (median T4 dose = 1.95 μg/kg per day; +30%; P < 0.0001). Once divided by patients' age, we observed that, after thyroidectomy and maintaining the same pre-surgical dose, serum TSH significantly increased both in younger and in older patients (median TSH = 4.57 and 6.11 mU/l respectively). Serum TSH was restored to the pre-surgical level by increasing the dose up to 1.95 and 1.77 μg/kg per day (+25 and +21%) respectively. CONCLUSIONS Following the same treatment regimen, a thyroidectomized patient requires one-third higher therapeutic T4 dose than before surgery. Despite this increase, the dose of T4 needed in our patients remains significantly lower than that previously described in athyreotic patients.
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Affiliation(s)
- S C Del Duca
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Corso della Repubblica 79, 04100 Latina, ItalyDepartment of Surgical Specialties and Organ Transplantation 'P. Stefanini'Policlinico Umberto I, 'Sapienza' University of Rome, Rome, ItalyEndocrinology UnitAUSL Latina, Latina, Italy
| | - M G Santaguida
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Corso della Repubblica 79, 04100 Latina, ItalyDepartment of Surgical Specialties and Organ Transplantation 'P. Stefanini'Policlinico Umberto I, 'Sapienza' University of Rome, Rome, ItalyEndocrinology UnitAUSL Latina, Latina, Italy
| | - N Brusca
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Corso della Repubblica 79, 04100 Latina, ItalyDepartment of Surgical Specialties and Organ Transplantation 'P. Stefanini'Policlinico Umberto I, 'Sapienza' University of Rome, Rome, ItalyEndocrinology UnitAUSL Latina, Latina, Italy
| | - I Gatto
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Corso della Repubblica 79, 04100 Latina, ItalyDepartment of Surgical Specialties and Organ Transplantation 'P. Stefanini'Policlinico Umberto I, 'Sapienza' University of Rome, Rome, ItalyEndocrinology UnitAUSL Latina, Latina, Italy
| | - M Cellini
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Corso della Repubblica 79, 04100 Latina, ItalyDepartment of Surgical Specialties and Organ Transplantation 'P. Stefanini'Policlinico Umberto I, 'Sapienza' University of Rome, Rome, ItalyEndocrinology UnitAUSL Latina, Latina, Italy
| | - L Gargano
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Corso della Repubblica 79, 04100 Latina, ItalyDepartment of Surgical Specialties and Organ Transplantation 'P. Stefanini'Policlinico Umberto I, 'Sapienza' University of Rome, Rome, ItalyEndocrinology UnitAUSL Latina, Latina, Italy
| | - C Verga Falzacappa
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Corso della Repubblica 79, 04100 Latina, ItalyDepartment of Surgical Specialties and Organ Transplantation 'P. Stefanini'Policlinico Umberto I, 'Sapienza' University of Rome, Rome, ItalyEndocrinology UnitAUSL Latina, Latina, Italy
| | - F M Frattaroli
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Corso della Repubblica 79, 04100 Latina, ItalyDepartment of Surgical Specialties and Organ Transplantation 'P. Stefanini'Policlinico Umberto I, 'Sapienza' University of Rome, Rome, ItalyEndocrinology UnitAUSL Latina, Latina, Italy
| | - C Virili
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Corso della Repubblica 79, 04100 Latina, ItalyDepartment of Surgical Specialties and Organ Transplantation 'P. Stefanini'Policlinico Umberto I, 'Sapienza' University of Rome, Rome, ItalyEndocrinology UnitAUSL Latina, Latina, Italy
| | - M Centanni
- Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Corso della Repubblica 79, 04100 Latina, ItalyDepartment of Surgical Specialties and Organ Transplantation 'P. Stefanini'Policlinico Umberto I, 'Sapienza' University of Rome, Rome, ItalyEndocrinology UnitAUSL Latina, Latina, Italy Department of Medico-Surgical Sciences and Biotechnologies'Sapienza' University of Rome, Corso della Repubblica 79, 04100 Latina, ItalyDepartment of Surgical Specialties and Organ Transplantation 'P. Stefanini'Policlinico Umberto I, 'Sapienza' University of Rome, Rome, ItalyEndocrinology UnitAUSL Latina, Latina, Italy
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Finzi A, Strobbe E, Tassi F, Fresina M, Cellini M. Hemifield pattern electroretinogram in ocular hypertension: comparison with frequency doubling technology and optical coherence tomography to detect early optic neuropathy. Clin Ophthalmol 2014; 8:1929-36. [PMID: 25284979 PMCID: PMC4181626 DOI: 10.2147/opth.s67193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND To assess the sensitivity and specificity of hemifield pattern electroretinogram (HF-PERG) for detecting early retinal ganglion cell (RGC) damage in ocular hypertensive (OH) patients. METHODS Fifty-two OH patients (mean age 56±9.6 years) with an intraocular pressure (IOP) .21 mmHg were assessed. All subjects underwent HF-PERG, optical coherence tomography (OCT), and frequency doubling technology (FDT) visual field. RESULTS OH patients showed a significant increase of peak-time of the N95 (P=0.027) compared to controls. The amplitude of the N95 of the lower and upper HF-PERG showed significant differences (P=0.037 and P=0.023, respectively) between the two groups. A significant intraocular (P=0.006) and interocular (P=0.018) asymmetry of N95 amplitude was found. Receiver operating characteristic (ROC) curve analysis revealed a sensitivity of 93% for the N95 of the lower HF-PERG, whereas full-field pattern electroretinogram (PERG) N95 peak-time had a sensitivity of 88%. In OH patients, we found a thinning of OCT - retinal nerve fiber layer (RNFL), especially in the superior and inferior quadrant, although not statistically significant, and a significantly higher FDT pattern standard deviation (FDT-PSD; P=0.001). In the OCT-RNFL inferior quadrant, a sensitivity of 82% was recorded. Finally, the sensitivity of the FDT-PSD was 92%. CONCLUSION Our study shows that HF-PERG is a very sensitive test for detecting early damage of the RGC.
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Affiliation(s)
- Alessandro Finzi
- Department of Specialized, Diagnostic and Experimental Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Ernesto Strobbe
- Department of Specialized, Diagnostic and Experimental Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Filippo Tassi
- Department of Specialized, Diagnostic and Experimental Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Michela Fresina
- Department of Specialized, Diagnostic and Experimental Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Mauro Cellini
- Department of Specialized, Diagnostic and Experimental Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
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Finzi A, Cellini M, Strobbe E, Campos EC. ET-1 plasma levels, choroidal thickness and multifocal electroretinogram in retinitis pigmentosa. Life Sci 2014; 118:386-90. [PMID: 24735956 DOI: 10.1016/j.lfs.2014.04.004] [Citation(s) in RCA: 18] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 03/14/2014] [Accepted: 04/03/2014] [Indexed: 12/31/2022]
Abstract
AIM To assess the relationship between both photoreceptor function and choroidal thickness and endothelin-1 (ET-1) plasma levels in patients with early stage retinitis pigmentosa (RP). MAIN METHODS We compared 24 RP patients (14 males and 10 females), 25 to 42 years of age (mean age: 34±7 years) with 24 healthy controls (12 males and 12 females) aged between 28 and 45 years (mean 36±6.8 years). All patients underwent visual field test, electroretinogram and multifocal-electroretinogram and choroidal thickness measurement by using spectral domain optical coherence tomography. KEY FINDINGS RP patients had a visual acuity of 0.95, a mean defect of the visual field of -7.90±1.75 dB, a pattern standard deviation index of 6.09±4.22 dB and a b-wave ERG amplitude of 45.08±8.24 μV. Notably RP subjects showed significantly increased ET-1 plasma levels and reduced choroidal thickness compared with controls: respectively, 2.143±0.258 pg/ml vs. 1.219±0.236 pg/ml; p<0.002 and 226.75±76.37 μm vs. 303.9±39.87 μm; p<0.03. Spearman's correlation test highlighted that the increase of ET-1 plasma levels was related with the decrease of choroidal thickness (r=-0.702; p<0.023) and the increase of implicit time in both ring 2 (r=-0.669; p<0.034) and ring 3 (r=-0.883; p<0.007) of mfERG. SIGNIFICANCE Increased ET-1 plasma levels may play a key role in the impairment of retinal and choroidal blood flow due to the vasoconstriction induced by ET-1. This could lead to worsening of the abiotrophic process of the macular photoreceptors.
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Affiliation(s)
- Alessandro Finzi
- Department of Specialized, Diagnostic and Experimental Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy.
| | - Mauro Cellini
- Department of Specialized, Diagnostic and Experimental Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Ernesto Strobbe
- Department of Specialized, Diagnostic and Experimental Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Emilio C Campos
- Department of Specialized, Diagnostic and Experimental Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy
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Mascarin M, Elia C, Bianchi M, Bertolini P, Buffardi S, Caniglia M, Caruso R, Cellini M, Cesaro S, Consarino C, D'Amico S, De Santis R, Farruggia P, Cecinati V, Garaventa A, Indolfi P, Moleti ML, Murgia G, Nardi M, Pierani P, Porta F, Rondelli R, Sala A, Santoro N, Todesco A, Zanazzo GA, Zecca M, Burnelli R. Lymphocyte Predominant Hodgkin Lymphoma. A Multicenter Retrospective 30-Year Experience of the Italian Pediatric Hematology and Oncology Association (AIEOP). Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Finzi A, Cellini M, Strobbe E, Campos E. ET-1 plasma levels, choroidal thickness and multifocal electroretinogram in retinitis pigmentosa. Life Sci 2013. [DOI: 10.1016/j.lfs.2013.12.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
PURPOSE The aim of this study was to assess (i) whether pupil dilation with tropicamide influences subfoveal choroidal blood flow, as assessed by continuous laser Doppler flowmetry (LDF) and (ii) if this is the case, whether the effect is due to a haemodynamic response of the drug-induced dilation. METHODS Following the instillation of one drop of 1% tropicamide in one eye of 18 healthy, nonsmoking volunteers (age 20-25 years), the subfoveal choroidal LDF parameters (Vel, Vol and ChBF) were recorded during 30 min, at 3-min intervals under two paradigms: through an artificial pupil (4 mm diameter) placed in front of the cornea (P1) and without this artificial pupil (P2). RESULTS Tropicamide increased the pupil diameter from 3.3 ± 0.4 mm (mean ± SD) to 8.3 ± .4 mm. Full dilation was reached at ~24 min. During this period of time, linear regression analysis demonstrated that none of the LDF parameters varied significantly (p > 0.05), either under P1 or P2. Based on a group of 12 subjects, the smallest (%) change in the mean value of ChBF (ChBFm ) that would be detectable (sensitivity of the method, S) was found to be 2% for P1 and 6% for P2. The average coefficient of variation of ChBFm based on eight measurements during dilation was greater for P2 than for P1 by a factor of approximately 2. CONCLUSION Tropicamide had no significant influence on the subfoveal choroidal LDF parameters measured by continuous LDF during pupil dilation. Furthermore, pupil dilation did not affect ChBFm by more than the calculated minimum percentage change of 6% detectable with our method.
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Affiliation(s)
- Nithiyanantham Palanisamy
- Department of Information Engineering, University of Modena and Reggio Emilia, Modena, ItalyProf.Emeritus, University of Lausanne, Lausanne, SwitzerlandDepartment of Specialistic Surgery and Anesthesiology Science, Ophthalmology Unit, University of Bologna, Bologna, Italy
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Cellini M, Balducci N, Strobbe E, Campos EC. Subtenon injection of natural leukocyte interferon α-2a in diabetic macular edema: a case report. BMC Ophthalmol 2013; 13:63. [PMID: 24165224 PMCID: PMC3829108 DOI: 10.1186/1471-2415-13-63] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 10/16/2013] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND To report the effect of subtenon injections of natural leukocyte interferon α-2a (IFNα) on best corrected visual acuity (BCVA) and central macular thickness (CMT) in a patient with diabetic macular edema (DME). CASE PRESENTATION A 66-year-old man affected by DME, with glycated hemoglobin (HbA1c) at 6.9%, refractory to laser grid treatment and intravitreal injections of triamcinolone, was selected to receive a cycle of three subtenon injections/week of IFNα (1×106 IU/ml). BCVA and CMT, using spectral domain ocular coherence tomography (SD-OCT), were evaluated preoperatively and at 1 week, 1 month, 4 months, and 1 year postoperatively. BCVA and CMT were significantly improved at 1 week after the three injections (20/200 vs. 20/40 and 498 μm vs. 237 μm, respectively). BCVA remained stable during the 1-year follow-up. CMT was slightly increased, but was still lower than the baseline value (215 μm, 255 μm, and 299 μm during the follow-up visits). No adverse events were recorded, with the exception of mild subconjunctival hemorrhage at the injection site. CONCLUSIONS IFNα, with its immunomodulatory, anti-proliferative and anti-angiogenic actions, was effective in improving BCVA and reducing CMT in refractory DME. Further randomized controlled studies are required to assess the effect of IFNα alone or in combination with other therapies for DME treatment.
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Affiliation(s)
- Mauro Cellini
- Department of Specialized, Diagnostic and Experimental Medicine, Ophthalmology Unit, University of Bologna, S. Orsola Malpighi-Hospital, Pelagio Palagi 9, Bologna 40138, Italy
| | - Nicole Balducci
- Department of Specialized, Diagnostic and Experimental Medicine, Ophthalmology Unit, University of Bologna, S. Orsola Malpighi-Hospital, Pelagio Palagi 9, Bologna 40138, Italy
| | - Ernesto Strobbe
- Department of Specialized, Diagnostic and Experimental Medicine, Ophthalmology Unit, University of Bologna, S. Orsola Malpighi-Hospital, Pelagio Palagi 9, Bologna 40138, Italy
| | - Emilio C Campos
- Department of Specialized, Diagnostic and Experimental Medicine, Ophthalmology Unit, University of Bologna, S. Orsola Malpighi-Hospital, Pelagio Palagi 9, Bologna 40138, Italy
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Strobbe E, Cellini M, Campos EC. Aqueous flare and choroidal thickness in patients with chronic hepatitis C virus infection: a pilot study. Ophthalmology 2013; 120:2258-63. [PMID: 23743439 DOI: 10.1016/j.ophtha.2013.03.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Revised: 03/11/2013] [Accepted: 03/27/2013] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To investigate the status of the blood-aqueous barrier and to evaluate the subfoveal choroidal thickness (SCT) in patients with asymptomatic untreated chronic hepatitis C virus (HCV) infection without any anterior or posterior ocular involvement and to search for possible correlations. DESIGN Observational case-control study. PARTICIPANTS AND CONTROLS A total of 80 eyes of 20 HCV-positive patients (male-to-female ratio, 12:8; mean age, 46.9±7.23 years) and 20 healthy controls (male-to-female ratio, 10:10; mean age, 48.2±8.71 years) were examined. METHODS Participants underwent a complete ophthalmologic examination. Aqueous flare was quantified objectively by using the noninvasive laser flare cell meter FC-500 (Kowa Company Ltd, Tokyo, Japan), whereas SCT was evaluated by using enhanced depth imaging optical coherence tomography (Spectralis OCT; Heidelberg Engineering GmbH, Heidelberg, Germany). A Wilcoxon rank-sum test was performed to compare ocular findings between HCV patients and controls, and correlations were assessed by using the Spearman rank test. MAIN OUTCOME MEASURES Retinal and choroidal thickness and anterior chamber inflammation of HCV patients and healthy controls. RESULTS Patients with HCV showed significantly higher aqueous flare values (8.37±2.25 photon counts/ms vs. 4.56±1.45 photon counts/ms; P<0.0001) and a significantly increased SCT (362.7±46.5 μm vs. 320.25±32.82 μm; P<0.0001) than healthy controls. Moreover, subjects with liver fibrosis had higher flare values than those with no significant hepatic fibrosis (9.62±1.99 photon counts/ms vs. 6.97±2.19 photon counts/ms; P = 0.0003) and thicker choroids (379.15±44.75 μm vs. 346.3±43.27 μm; P = 0.024). Statistical analysis revealed that there was a positive correlation between aqueous flare values and SCT in HCV patients (r = 0.69; P<0.0001) and between flare and the degree of liver fibrosis (r = 0.67; P = 0.0001). CONCLUSIONS This study showed that impairment of the blood-aqueous barrier and thickened choroids are features of asymptomatic HCV patients, and that choroidal thickness increases as the degree of subclinical inflammation of the anterior chamber increases. Patients with significant liver fibrosis have the highest flare values and the thickest choroids.
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Affiliation(s)
- Ernesto Strobbe
- Ophthalmology Unit, Department of Experimental, Diagnostic, and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
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Strobbe E, Cellini M, Campos EC. Effectiveness of palmitoylethanolamide on endothelial dysfunction in ocular hypertensive patients: a randomized, placebo-controlled cross-over study. Invest Ophthalmol Vis Sci 2013; 54:968-73. [PMID: 23307959 DOI: 10.1167/iovs.12-10899] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We assessed the effect of palmitoylethanolamide (PEA) on systemic endothelial function in ocular hypertensive patients (OH). METHODS We enrolled in this randomized, double-blind, placebo-controlled, crossover single-center study 40 never-treated OH patients and 40 healthy age-matched controls. At baseline, each participant underwent endothelium-dependent flow-mediated vasodilation (FMD) measurement using a noninvasive high-resolution 2-dimensional ultrasonographic imaging of the brachial artery. OH patients were assigned randomly to receive either 300 mg PEA (Group A) or a matching placebo (Group B), twice a day for three months (T1). The first medication period was followed by a two-month washout period (T2), and then patients switched to PEA or placebo (depending on the first drug received) for another three months (T3). FMD evaluations were repeated at T1, T2, and T3. RESULTS At baseline FMD values in OH patients and controls were 6.06 ± 0.60% vs. 10.85 ± 1.80%, respectively (P < 0.001). At T1, FMD and IOP of Group A were, respectively, 8.46 ± 1.09% vs. 6.08 ± 0.62% (P < 0.001, r = 0.96) and 22.18 ± 1.26 vs. 23.03 ± 0.88 mm Hg (P < 0.001). At T2, Group A had better FMD values than at baseline (6.59 ± 0.33% vs. 6.08 ± 0.62%, P < 0.05). At T3, subjects in Group B showed better FMD and IOP than at T2 (8.52 ± 1.07% vs. 6.05 ± 0.68%, P < 0.001, r = 0.97; and 22.43 ± 1.17 vs. 23.03 ± 0.83 mm Hg, P < 0.01, respectively). No side effects were observed. CONCLUSIONS Three-month PEA intake reduced IOP and led to significantly improved FMD values in OH patients compared to placebo, by ameliorating peripheral endothelial function, and its positive effect lasted longer than the period of PEA consumption. No adverse events were recorded. (Controlled-trials.com number, ISRCTN72647928.).
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Affiliation(s)
- Ernesto Strobbe
- Department of Surgery Science and Anesthesiology, Ophthalmology Unit, University of Bologna, Italy.
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Cellini M, Toschi PG, Strobbe E, Balducci N, Campos EC. Frequency doubling technology, optical coherence technology and pattern electroretinogram in ocular hypertension. BMC Ophthalmol 2012; 12:33. [PMID: 22853436 PMCID: PMC3444883 DOI: 10.1186/1471-2415-12-33] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 06/27/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To assess which of three methods, namely, optical coherence tomography (OCT), pattern electroretinogram (PERG) or frequency-doubling technology (FDT), is the most sensitive and specific for detecting early glaucomatous damage in ocular hypertension (OH). METHODS Fifty-two patients with OH (24 men and 28 women, mean age of 56 ± 9.6 years) with an intraocular pressure (IOP) > 21 mm Hg and fifty-two control patients (25 men and 27 women, mean age of 54.8 ± 10.4 years) with IOP < 21 mm Hg, were assessed. All the patients had normal visual acuity, normal optic disk and normal perimetric indices.All subjects underwent OCT, FDT and PERG. Data were analyzed with unpaired t-tests, Chi-square test and Receiver Operating Characteristic (ROC) curve analyses. RESULTS In patients with OH, OCT showed retinal nerve fiber layer (RNFL) thinner than in control group in the superior quadrant (130.16 ± 10.02 vs 135.18 ± 9.27 μm, respectively; p < 0.011) and inferior quadrant (120.14 ± 11.0 vs 132.68 ± 8.03 μm; p < 0.001). FDT showed a significantly higher pattern standard deviation (PSD) (3.46 ± 1.48 vs 1.89 ± 0.7 dB; p < 0.001). With respect to PERG, only the amplitude showed significant differences (p < 0.044) between the two groups. ROC curve analysis revealed a sensitivity and specificity of 92% and 86%, respectively, for FDT-PSD (with an area under the ROC curve of 0.940), whereas with OCT, a sensitivity of 82% and a specificity of 74% was recorded in the inferior RNFL quadrant (with an area under the ROC curve of 0.806) finally with PERG amplitude we found a sensitivity of 52% and specificity of 77% (with an area under the ROC curve of 0.595). CONCLUSIONS FDT is the most sensitive and specific method for detecting early glaucomatous damage in eyes with OH, and together with OCT, can be useful in identifying those patients who may develop glaucoma. TRIAL REGISTRATION ISRCT number: ISRCTN70295497.
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Affiliation(s)
- Mauro Cellini
- Department of Specialistic Surgery and Anesthesiology Science, Ophthalmology Service, University of Bologna, Via Palagi 9, Bologna, Italy
| | - Pier Giorgio Toschi
- Department of Specialistic Surgery and Anesthesiology Science, Ophthalmology Service, University of Bologna, Via Palagi 9, Bologna, Italy
| | - Ernesto Strobbe
- Department of Specialistic Surgery and Anesthesiology Science, Ophthalmology Service, University of Bologna, Via Palagi 9, Bologna, Italy
| | - Nicole Balducci
- Department of Specialistic Surgery and Anesthesiology Science, Ophthalmology Service, University of Bologna, Via Palagi 9, Bologna, Italy
| | - Emilio C Campos
- Department of Specialistic Surgery and Anesthesiology Science, Ophthalmology Service, University of Bologna, Via Palagi 9, Bologna, Italy
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Cellini M, Strobbe E, Gizzi C, Balducci N, Toschi PG, Campos EC. Endothelin-1 plasma levels and vascular endothelial dysfunction in primary open angle glaucoma. Life Sci 2012; 91:699-702. [PMID: 22406080 DOI: 10.1016/j.lfs.2012.02.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Revised: 02/10/2012] [Accepted: 02/13/2012] [Indexed: 10/28/2022]
Abstract
AIMS To assess the relationship between endothelial dysfunction, endothelin 1 (ET-1) plasma levels and subclinical inflammation in primary open angle glaucoma (POAG) patients. MAIN METHODS We enrolled 40 POAG patients with progressive visual field damage, although well controlled intraocular pressure (IOP) and compared to age and sex matched healthxy subjects. Each patient underwent an ophthalmological examination, a standard achromatic perimetry (SAP), blood sampling to assess ET-1 plasma levels, an objective assessment of cellularity within the anterior chamber (FLARE) and measurement of flow mediated dilation (FMD) with high resolution 2-dimensional ultrasonographic imaging of the brachial artery. KEY FINDINGS At baseline, POAG patients, compared to healthy controls, showed an increase of ET-1 plasma levels: 2.83 ± 0.28 pg/ml vs. 1.75 ± 0.25 pg/ml (p<0.001), lower FMD values 4.46 ± 1.28% vs. 13.18 ± 2.80% (p<0.001) and increased FLARE values 9.98 ± 0.97 photons/ms vs. 5.87 ± 0.64 photons/ms (p<0.001). A follow up after 1 year revealed a further increase of ET-1 plasma levels (to 3.68 ± 0.60; p<0.001) and decrease of FMD (3.52 ± 1.28; p>0.001). SIGNIFICANCE The increase of ET-1 in POAG patients is related to vascular dysfunction (r=0.942; p=0.001) and vascular dysfunction is related to sub-clinical intraocular inflammation (r=0.968; p=0.001). Thus ET-1 and vascular dysfunction related to sub-clinical inflammation may play a key role in determining a progressive visual field damage in POAG patients who present a well-controlled IOP.
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Affiliation(s)
- Mauro Cellini
- Department of Specialistic Surgery and Anesthesiology Science-Ophthalmology, Service, University of Bologna, Italy.
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Cellini M, Strobbe E, Toschi PG, Campos EC. Secondary IOL Implantation without Capsular Support: A Laser Flare Cell Meter Study. ISRN Ophthalmol 2012; 2011:653246. [PMID: 24533188 PMCID: PMC3912603 DOI: 10.5402/2011/653246] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 12/08/2011] [Indexed: 11/29/2022]
Abstract
Phacoemulsification and the contemporary implantation of intraocular lens (IOL) within the capsular bag represent the standard of care in cataract surgery, but sometimes a primary IOL implant is not possible due to intraoperative complications or preexisting conditions so that a secondary implantation of IOL within the anterior or posterior chamber is necessary.
The aim of our study was to assess the degree of inflammation due to a secondary implant of claw lenses, angle-supported IOLs, and scleral-fixated IOLs by means of an objective, repeatable, and noninvasive device, the laser flare cell meter, which evaluates aqueous flare and cells within the anterior chamber in vivo and to show the contribution of the single IOLs to the genesis of inflammation.
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Affiliation(s)
- Mauro Cellini
- Department of Surgery Science and Anesthesiology, Ophthalmology Service, University of Bologna, Via Palagi 9, 40138 Bologna, Italy
| | - Ernesto Strobbe
- Department of Surgery Science and Anesthesiology, Ophthalmology Service, University of Bologna, Via Palagi 9, 40138 Bologna, Italy
| | - Pier Giorgio Toschi
- Department of Surgery Science and Anesthesiology, Ophthalmology Service, University of Bologna, Via Palagi 9, 40138 Bologna, Italy
| | - Emilio C Campos
- Department of Surgery Science and Anesthesiology, Ophthalmology Service, University of Bologna, Via Palagi 9, 40138 Bologna, Italy
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Cellini M, Gattegna R, Toschi PG, Strobbe E, Campos EC. Multifocal electroretinogram and Optical Coherence tomography spectral-domain in arc welding macular injury: a case report. BMC Ophthalmol 2011; 11:40. [PMID: 22208163 PMCID: PMC3274443 DOI: 10.1186/1471-2415-11-40] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [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: 03/08/2011] [Accepted: 12/30/2011] [Indexed: 11/14/2022] Open
Abstract
Background the purpose of this study was to report a binocular photic retinal injury induced by plasma arc welding and the follow-up after treatment with vitamin supplements for a month. In our study, we used different diagnostic tools such as fluorescein angiography (FA), optical coherence tomography (OCT) and multifocal electroretinogram (mfERG). Case presentation in the first visit after five days from arc welding injury in the left eye (LE) the visual acuity was 0.9 and 1.0 in the right eye (RE). FA was normal in both eyes. OCT in the left eye showed normal profile and normal reflectivity and one month later, a hyperreflectivity appeared in the external limiting membrane (ELM). The mfERG signal in the LE was 102.30 nV/deg2 five days after the injury and 112.62 nV/deg2 after one month and in the RE respectively 142.70 nV/deg2 and 159.46 nV/deg2. Conclusions in cases of retinal photo injury it is important for the ophthalmologist to evaluate tests such as OCT and the mfERG in the diagnosis and follow-up of the patient because the recovery of visual acuity cannot exclude the persistence of phototoxic damage charged to the complex inner-outer segment of photoreceptors.
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Affiliation(s)
- Mauro Cellini
- Department of Specialistic Surgery and Anesthesiology Science, University Ophthalmology Unit, S Orsola Malpighi-Hospital, Pelagio Palagi 9, Bologna 40138, Italy.
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Chiappini E, Galli L, Lisi C, Gabiano C, Giaquinto C, Giacomet V, Buffolano W, Esposito S, Badolato R, Berbardi S, Cellini M, Dodi I, Faldella G, Osimani P, Genovese O, Nicastro E, Viscoli C, Salvini F, Tovo PA, Maurizio DM. Risk of Perinatal HIV Infection in Infants Born in Italy to Immigrant Mothers. Clin Infect Dis 2011; 53:310-3. [DOI: 10.1093/cid/cir344] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Cellini M, Strobbe E, Gizzi C, Campos EC. ET-1 plasma levels and ocular blood flow in retinitis pigmentosaThis article is one of a selection of papers published in the two-part special issue entitled 20 Years of Endothelin Research. Can J Physiol Pharmacol 2010; 88:630-5. [DOI: 10.1139/y10-036] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Retinitis pigmentosa (RP) is an inherited retinal disorder clinically characterized by a pale, waxy optic nerve head, attenuated retinal blood vessels, and bone spicule pigment in the retina. Hemodynamic studies have demonstrated that RP is associated with a reduction in the retinal and choroidal blood flow. Retinal hemodynamic impairment is also present in early stages of RP, and various hypotheses have been advanced as to the cause. The authors studied 20 patients, 12 males and 8 females, aged 26–42 years (mean 35.1 years) and affected by simplex RP. The patients had a visual acuity of 0.9 ± 0.1, visual field mean defect of –6.52 ± 3.58 dB, and b-wave electroretinogram amplitude of 260.08 ± 8.24 µV. An increase in plasma levels of endothelin-1 (ET-1) was found: 1.910 ± 0.317 pg/mL versus 1.180 ± 0.210 pg/mL in non-RP controls (p < 0.02). Moreover both an ocular and systemic vascular impairment was detected by means of color Doppler imaging and laser Doppler flowmetry performed during a cold pressor test. We found a correlation between the increase of ET-1 plasma levels in RP and the decrease of peak systolic velocity in the ophthalmic artery (p < 0.03) and in the posterior ciliary arteries (p < 0.006). It is thought that an increase of ET-1 and retinal oxygen levels in RP could lead to vasoconstriction and a decrease of the retinal blood flow, worsening the abiotrophic process.
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Affiliation(s)
- Mauro Cellini
- Department of Surgery and Anesthesiology Science, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Ernesto Strobbe
- Department of Surgery and Anesthesiology Science, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Corrado Gizzi
- Department of Surgery and Anesthesiology Science, Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Emilio C. Campos
- Department of Surgery and Anesthesiology Science, Ophthalmology Service, University of Bologna, Bologna, Italy
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Cellini M, Fresina M, Strobbe E, Gizzi C, Campos EC. Corneoscleral graft in Mooren's ulcer: a case report. Cases J 2009; 2:180. [PMID: 19946490 PMCID: PMC2783135 DOI: 10.1186/1757-1626-2-180] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Accepted: 11/02/2009] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Mooren's ulcer is a rare disorder of unknown etiology that is refractory to treatment. It can affect not just the cornea but also the scleral tissue and can involve both eyes. CASE PRESENTATION We report a case of a 74-year-old man with a history of bilateral and malignant Mooren's ulcer. The patient had undergone an exenteratio bulbi of the left eye because of the perforation of a Mooren's corneal ulcer. The perforated Mooren's corneal ulcer also presented in the right eye and involved the adjacent scleral tissue. It was decided to perform a corneal-scleral graft to preserve the anatomical integrity of the eye. CONCLUSION This report highlights how a corneal-scleral graft followed by systemic and local immunosuppressive treatment should be considered in monocular patients with malignant Mooren's ulcer where there is serious damage to the corneal and scleral tissue.
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Affiliation(s)
- Mauro Cellini
- Department of Surgery Science and Anesthesiology University of Bologna, Ophthalmology Service, Via Palagi 9 - 40138 Bologna, Italy
| | - Michela Fresina
- Department of Surgery Science and Anesthesiology University of Bologna, Ophthalmology Service, Via Palagi 9 - 40138 Bologna, Italy
| | - Ernesto Strobbe
- Department of Surgery Science and Anesthesiology University of Bologna, Ophthalmology Service, Via Palagi 9 - 40138 Bologna, Italy
| | - Corrado Gizzi
- Department of Surgery Science and Anesthesiology University of Bologna, Ophthalmology Service, Via Palagi 9 - 40138 Bologna, Italy
| | - Emilio C Campos
- Department of Surgery Science and Anesthesiology University of Bologna, Ophthalmology Service, Via Palagi 9 - 40138 Bologna, Italy
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Chiappini E, Galli L, Tovo PA, Gabiano C, Lisi C, Ferraris G, Viganò A, Giaquinto C, Bernardi S, Badolato R, Genovese O, Salvini F, Maccabruni A, Anzidei G, Rosso R, Buffolano W, Cellini M, Casadei AM, Faldella G, Ruggeri M, Osimani P, Manzionna MM, Dodi I, Gotta C, Esposito S, Gariel D, De Martino M. Low prevalence of selective IgA deficiency in infected children born to HIV-seropositive mothers: an in vivo model for speculation on selective IgA deficiency pathogenesis. Int J Immunopathol Pharmacol 2009; 21:1035-9. [PMID: 19144291 DOI: 10.1177/039463200802100430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Anecdotal reports of restored immunoglobulin production in individuals with common variable immunodeficiency after acquiring HIV infection suggest that perturbation of the immune system occurring during HIV infection may force some underlying functional defects. These findings raise intriguing questions about the pathogenesis of common variable immunodeficiency. No study has investigated the possible influence of HIV infection on the development of selective IgA deficiency, a primary immunologic defect genetically related to common variable immunodeficiency. IgA serum levels were evaluated in a large cohort of children born to HIV-infected mothers from 1985 to 2006. To avoid differences possibly due to different follow-up durations we considered only infected and non-infected children aged over 4 years at last-follow-up. The study included 1,157 non-infected children and 964 infected children, aged ≥ 4 years at last-follow-up and with availability of two or more serum IgA determinations over six months of age. No child displayed immunoglobulin values compatible with diagnosis of common variable immunodeficiency. However, 0/964 infected children vs. 5/1157 non-infected children had selective IgA deficiency (P=0.048). It may be speculated that several immunological alterations, occurring simultaneously in perinatal HIV infection, surpass the functional defect exhibited in some children with selective IgA deficiency. Our data may shed light on the pathogenesis of selective IgA deficiency.
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Cellini M, Leonetti P, Strobbe E, Campos EC. Matrix metalloproteinases and their tissue inhibitors after selective laser trabeculoplasty in pseudoexfoliative secondary glaucoma. BMC Ophthalmol 2008; 8:20. [PMID: 18939999 PMCID: PMC2575190 DOI: 10.1186/1471-2415-8-20] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Accepted: 10/21/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to assess changes in metalloproteinases (MMP-2) and tissue inhibitor of metalloproteinases (TIMP-2) following selective laser trabeculoplasty (SLT) in patients with pseudoexfoliative glaucoma (PEXG). METHODS We enrolled 15 patients with PEXG and cataracts (PEXG-C group) and good intraocular pressure (IOP) controlled with beta-blockers and dorzolamide eye drops who were treated by cataract phacoemulsification and 15 patients with pseudoexfoliative glaucoma (PEXG-SLT group). The PEXG-SLT patients underwent a trabeculectomy for uncontrolled IOP in the eye that showed increased IOP despite the maximum drug treatment with beta-blockers and dorzolamide eye drops and after ineffective selective laser trabeculoplasty (SLT). The control group consisted of 15 subjects with cataracts. Aqueous humor was aspirated during surgery from patients with PEXG-C, PEXG-SLT and from matched control patients with cataracts during cataract surgery or trabeculectomy. The concentrations of MMP-2 and TIMP-2 in the aqueous humor were assessed with commercially available ELISA kits. RESULTS In PEXG-SLT group in the first 10 days after SLT treatment a significant reduction in IOP was observed: 25.8 +/- 1.9 vs 18.1.0 +/- 1.4 mm/Hg (p < 0.001), but after a mean time of 31.5 +/- 7.6 days IOP increased and returned to pretreatment levels: 25.4 +/- 1.6 mm/Hg (p < 0.591). Therefore a trabeculectomy was considered necessary.The MMP-2 in PEXG-C was 57.77 +/- 9.25 microg/ml and in PEXG-SLT was 58.52 +/- 9.66 microg/ml (p < 0.066). TIMP-2 was 105.19 +/- 28.53 microg/ml in PEXG-C and 105.96 +/- 27.65 microg/ml in PEXG-SLT (p < 0.202). The MMP-2/TIMP-2 ratio in the normal subjects was 1.11 +/- 0.44. This ratio increase to 1.88 +/- 0.65 in PEXG-C (p < 0.001) and to 1.87 +/- 0.64 in PEXG-SLT (p < 0.001). There was no statistically significant difference between the PEXG-C and PEXG-SLT ratios (p < 0.671). CONCLUSION This case series suggest that IOP elevation after SLT can be a serious adverse event in some PEXG patients. The IOP increase in these cases would be correlated to the failure to decrease the TIMP-2/MMP-2 ratio. TRIAL REGISTRATION Current Controlled Trials ISRCTN79745214.
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Affiliation(s)
- Mauro Cellini
- Department of Surgery Science and Anesthesiology, Ophthalmology Service, University of Bologna, Italy.
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Cellini M, Pazzaglia A, Zamparini E, Leonetti P, Campos EC. Intravitreal vs. subtenon triamcinolone acetonide for the treatment of diabetic cystoid macular edema. BMC Ophthalmol 2008; 8:5. [PMID: 18366650 PMCID: PMC2277375 DOI: 10.1186/1471-2415-8-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [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: 11/04/2007] [Accepted: 03/17/2008] [Indexed: 11/10/2022] Open
Abstract
Background To assess the efficacy of the intravitreal (IVT) injection of Triamcinolone Acetonide (TA) as compared to posterior subtenon (SBT) capsule injection for the treatment of cystoid diabetic macular edema. Methods Fourteen patients with type II diabetes mellitus and on insulin treatment, presenting diffuse cystoid macular edema were recruited. Before TA injection all focal lakes were treated by laser photocoagulation. In the same patients one eye was assigned to 4 mg IVT injection of TA and the fellow eye was then treated with 40 mg SBT injection of TA. Before and one, three and six months after treatment we measured visual acuity with ETDRS chart as well as thickness of the macula with optical coherence tomography (OCT) and intraocular pressure (IOP). Results The eyes treated with an IVT injection displayed significant improvement in visual acuity, both after one (0.491 ± 0.070; p < 0.001) and three months (0.500 ± 0.089; p < 0.001) of treatment. Significant improvement was displayed also in eyes treated with an SBT injection, again after one (0.455 ± 0.069; p < 0.001) and three months (0.427 ± 0.065; p < 0.001). The difference between an IVT injection (0.809 ± 0.083) and SBT injection (0.460 ± 0.072) becomes significant six months after the treatment (p < 0.001). Macular thickness of the eyes treated with IVT injection was significantly reduced both after one (222.7 ± 13.4 μm; p < 0.001) and after three months (228.1 ± 10.6 μm; p < 0.001) of treatment. The eyes treated with SBT injection displayed significant improvement after one (220.1 ± 15.1 μm; p < 0.001) and after three months (231.3 ± 10.9 μm; p < 0.001). The difference between the eyes treated with IVT injection (385.2 ± 11.3 μm) and those treated with SBT injection (235.4 ± 8.7 μm) becomes significant six months after the treatment (p < 0.001). Intraocular pressure of the eyes treated with IVT injection significantly increased after one month (17.7 ± 1.1 mm/Hg; p < 0.020), three (18.2 ± 1.2 mm/Hg; p < 0.003) and six month (18.1 ± 1.3 mm/Hg; p < 0.007) when compared to baseline value (16.1 ± 1.402 mm/Hg). In the SBT injection eyes we didn't display a significant increase of intraocular pressure after one (16.4 ± 1.2 mm/Hg; p < 0.450), three (16.3 ± 1.1 mm/Hg; p < 0.630) and six months (16.2 ± 1.1 mm/Hg; p < 0.720) when compared to baseline value (16.2 ± 1.3 mm/Hg). Conclusion The parabulbar subtenon approach can be considered a valid alternative to the intravitreal injection. Trial registration Current Controlled Trials ISRCTN67086909
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Affiliation(s)
- Mauro Cellini
- Department of Surgery and Transplant A, Valsalva, Ophthalmology Service (Chief: Prof, E,C, Campos), University of Bologna, Italy.
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Potena A, Simoni M, Cellini M, Cartabellotta A, Ballerin L, Piattella M, Putinati S. Management of community-acquired pneumonia by trained family general practitioners. Int J Tuberc Lung Dis 2008; 12:19-25. [PMID: 18173872] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
SETTING Community-acquired pneumonia (CAP) is a respiratory health disease with a high prevalence in the general population. Family general practitioners (GPs) can play an important role in CAP management by reducing unnecessary hospital admissions and, consequently, national health costs. OBJECTIVE To assess CAP management by trained GPs. DESIGN A course in CAP management, including a risk classification method based only on clinical criteria, was developed within the framework of an educational programme. GPs who participated in the programme (n = 220) were asked to collect data on their CAP patients. RESULTS GPs (n = 94, response rate 42.7%) provided information on 370 patients (50% males, aged 18-93 years). The numbers of patients judged to be at low, moderate and high risk were 81%, 13% and 6%, respectively. The admission rate was 19.5%. All home-treated patients had good clinical outcomes. Home treatment was based on quinolones (62%), beta-lactams (23%) and macrolides (15%). The attributable economic mean cost of antibiotic home treatment was euro 96 per episode (standard deviation 71, range 17-445). CONCLUSIONS The good outcomes suggest that GPs managed their CAP patients well, adhering to the content of the CAP management course. The risk evaluation of patients admitted to hospital, based exclusively on clinical elements, was consistent with more complex classification.
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Affiliation(s)
- A Potena
- Respiratory Physio-Pathology Unit, Azienda Ospedaliero-Universitaria, Ferrara, Italy.
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Cellini M, Versura P, Leonetti P, Frigato M, Manfredini E, Malavolta N, Campos EC. Ocular surface and intraocular inflammation are related in SS-I and rheumatoid arthritis patients. Rheumatol Int 2007; 27:853-7. [PMID: 17297622 DOI: 10.1007/s00296-007-0325-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 10/22/2006] [Accepted: 01/18/2007] [Indexed: 10/23/2022]
Abstract
The purpose of this study is to evaluate the intraocular inflammation at a sub clinical level, in patients suffering from Sjogren's syndrome (SS-I) and Rheumatoid Arthritis (RA), to relate it with the ocular surface status and to verify the diagnostic performance of the method. Twenty-eight patients suffering from SS-I, 31 patients suffering from RA and 31 normal subjects matched in age and gender were included in the study. A Kowa 500F laser cell flare meter was utilized to quantify the aqueous cells and flare in vivo, ocular surface inflammation was graded by conjunctival cytology and dosage of serum albumin in tears, eye dryness was scored with Tear Function Index. All data resulted significantly different in both SS-I and RA patients vs. control group and also different comparing SS-I vs. RA patients group, except for the Flare values. A blood-aqueous barrier breakdown occurs either in SS-I and RA patients; the degree of the damage is related with ocular surface inflammation and dryness. We recommend the aqueous flare be analysed in those rheumatic patients where an ocular surface inflammation has been documented.
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Affiliation(s)
- Mauro Cellini
- Department of Surgical Science and Transplants, Sect. Ophthalmology, Alma Mater Studiorum Università di Bologna, Policlinico S.Orsola, Via Massarenti, 9 - 40138 Bologna, Italy.
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Cellini M, Bendo E, Bravetti GO, Campos EC. The Use of Nerve Growth Factor in Surgical Wound Healing of the Cornea. Ophthalmic Res 2006; 38:177-81. [PMID: 16679804 DOI: 10.1159/000092626] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [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: 09/05/2005] [Accepted: 12/15/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND Recent studies have shown how the topical application of nerve growth factor (NGF) has led to the repair of neurotrophic corneal ulcers with recovery of corneal surface sensitivity. The biological effect of NGF, at a corneal level, is mediated by the presence of specific receptors localized on the surfaces of the corneal and conjunctival cells. OBJECTIVES To evaluate the efficacy of NGF to promote corneal wound healing after cataract surgery. METHODS Thirty patients were divided into two groups (groups A and B) and underwent cataract surgery. After surgery patients in group A received 1 drop of NGF solution (10 microg of NGF dissolved in 50 microl of saline solution, 0.9% of sodium chloride) in the conjunctival fornix every 2 h (from 6 a.m. to 12 p.m.) for 2 weeks and then 4 times a day for another week. The patients in group B received 1 drop of hyaluronic acid 0.2% eye drops in the conjunctival fornix every 2 h for 2 weeks and then 4 times a day for another week. With optical coherence tomography (OCT) we evaluated the corneal thickness at the side of the surgical wound, the endothelial cell count and the incision line in the stroma 1, 7 and 21 days after surgery. RESULTS Before surgery in group A and in group B, the endothelial cell count was 2,607.4 +/- 261.0 versus 2,602.0 +/- 266.6 (p < 0.991), and the temporal cornea edge thickness was 639.2 +/- 24.7 versus 644.4 +/- 31.9 microm (p < 0.605), respectively. At 24 h after surgery, the results were: 2,523.2 +/- 280.5 versus 2,528.2 +/- 235.7 (p < 0.988) and 804.4 +/- 29.5 versus 802.6 +/- 35.0 microm (p < 0.953). After 7 days the cell count values were: 2,511.4 +/- 229.8 versus 2,490.0 +/- 230.4 (p < 0.361) and corneal thickness 713.6 +/- 16.5 versus 771.4 +/- 36.5 microm (p < 0.047). Finally, 21 days after surgery, the number of endothelial cells was 2,540.2 +/- 237.3 versus 2,503.4 +/- 224.5 (p < 0.382) and corneal thickness 645.2 +/- 22.6 versus 704.2 +/- 11.8 microm (p < 0.002). In the patients treated with NGF, on day 21, we found with OCT a complete wound healing, and the stromal incision was not visible. CONCLUSIONS This clinical experience shows that the topical administration of NGF is effective in accelerating the healing of surgical corneal wounds.
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Affiliation(s)
- M Cellini
- Ophthalmology Service, Department of Surgery and Transplantation A. Valsalva, University of Bologna, Via Massarenti 9, IT-40138 Bologna, Italy.
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Cellini M, Bernabini B, Carbonelli M, Zamparini E, Campos EC. Optical coherence tomography, frequency-doubling technology, and colour Doppler imaging in ocular hypertension. Eye (Lond) 2006; 21:1071-7. [PMID: 16888642 DOI: 10.1038/sj.eye.6702412] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To study in ocular hypertension (OH) the retinal nerve fibre layer (RNFL) with optical coherence tomography (OCT) and the neuronal function with frequency-doubling technology (FDT) to assess which of the two methods was more sensitive in detecting early glaucomatous damage. Furthermore, a colour Doppler imaging (CDI) of the optic nerve was carried out to highlight any correlation with RNFL thickness and FDT abnormality. MATERIALS AND METHODS We enrolled 28 ocular hypertensive patients who underwent OCT of the RNFL and FDT. Moreover, we performed a CDI of the ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary arteries (PCAs). RESULTS The patients with OH following OCT revealed a significant thinning in the RNFL as compared to the control group only in the inferior quadrant: 122.250+/-14.091 vs131.750+/-10.729 mum (P<0.045). As regards FDT, there was a significant difference between the two groups only for pattern standard deviation (PSD): 3.873+/-1.488 vs1.938+/-0.704 dB (P<0.044). In OH and in the control group, CDI resistance index (RI) in the OA was 0.768+/-0.012 vs0.745+/-0.019 (P<0.022), in the CRA was 0.66+/-0.012 vs0.645+/-0.019 (P<0.032), and in PCAs was 0.673+/-0.039 vs0.622+/-0.012 (P<0.037). The OCT had a sensitivity of 83% but only in the inferior RNFL quadrant. The FDT-PSD revealed a sensitivity of 85%. CONCLUSIONS Both FDT and OCT detect early glaucomatous damage with a slightly superior sensitivity of FDT vsOCT. The CDI measurements suggest that circulatory abnormalities may have a role in the development of OCT and FDT damage.
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Affiliation(s)
- M Cellini
- Department of Surgery and Transplant- Ophthalmology Service, A. Valsalva, University of Bologna, Bologna, Italy.
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Cellini M, Versura P, Zamparini E, Bendo E, Campos EC. Effects of endothelin-1 and flunarizine on human trabecular meshwork cell contraction. Exp Biol Med (Maywood) 2006; 231:1081-4. [PMID: 16741053] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
Trabecular meshwork (TM) cells are now considered to play an active role in the aqueous outflow mechanism because they exhibit smooth muscle-like contractile properties. Endothelin-1 (ET-1), a potent vasoconstrictor peptide, has been proposed to play a role in the local regulation of aqueous outflow and intraocular pressure (IOP) control. We propose an in vitro culture model as a method for the study of ET-1-induced human TM (HTM) cell contractility and for the study of whether pre-incubation with flunarizine, a calcium-channel blocker, can inhibit the action of ET-1. Experiments were performed on semiconfluent HTM cells (primary cultures established from normotensive human donor eyes) at the second passage, with phosphate-buffered saline (PBS) as a control. The contractile status of the cells was evaluated by a morphometric analysis of cell area, assuming that HTM cells in culture are able to reduce their area as a consequence of cytoskeletal contraction, rather than regulatory volume decrease. After incubation with 10 microM ET-1 for 5 mins, we observed a reduction of HTM cell area with respect to PBS-treated cells: 2425 +/- 876 microm2 versus 3125 +/- 987 microm2 (P < 0.001); and cells exhibited a retraction in shape and a reduction in number of indented profiles. Administration of ET-1 at progressively lower doses produced a corresponding lower reduction of HTM cell area, suggesting a dose-response effect of ET-1. Pre-incubation with 10 microM flunarizine strongly inhibited the ET-1 effect on HTM cell contraction: 2806 +/- 865 microm2 versus 2910 +/- 846 microm2 (P = not significant). Our data indicate that ET-1 induced a statistically significant reduction in the area of HTM cells versus controls, and that ET-1 can directly influence the aqueous outflow. Moreover, we observed that flunarizine inhibited the effect of ET-1 on the HTM cells.
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Affiliation(s)
- Mauro Cellini
- Department of Surgery and Transplant-Section Ophthalmology I, Alma Mater Studiorum University of Bologna, Via Massarenti, 9, I-40138 Bologna, Italy.
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Scapellato M, Marcuzzo G, Mastrangelo G, Sessa G, Cellini M, De Rosa E, Saia B, Bartolucci G. Environmental and Biological Monitoring of Styrene Exposure: Urinary Excretion of D‐Glucaric Acid Compared with Exposure Indices. J Occup Health 2006. [DOI: 10.1539/joh.40.313] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- M.L. Scapellato
- Istituto di Medicina del Lavoro, Università degli Studi di Padova
| | - G. Marcuzzo
- Istituto di Medicina del Lavoro, Università degli Studi di Padova
| | - G. Mastrangelo
- Istituto di Medicina del Lavoro, Università degli Studi di Padova
| | - G. Sessa
- S.M.P.I.L. ‐ Azienda U.S.L. di Ferrara
| | | | - E. De Rosa
- Cattedra di Medicina del Lavoro, Università degli Studi di Ferrara
| | - B. Saia
- Istituto di Medicina del Lavoro, Università degli Studi di Padova
| | - G.B. Bartolucci
- Istituto di Medicina del Lavoro, Università degli Studi di Padova
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Abstract
OBJECTIVE To evaluate the diagnostic performance of the tests included in primary Sjogren's syndrome (SS-I) diagnostic criteria (Schirmer I, break-up time, vital dye staining) and to compare them with other examinations related to the ocular surface status. METHODS Clinical and cytological data were collected from 177 patients (62 SS-1, 56 non-SS autoimmune diseases, 59 Sicca syndrome). Tear tests included: a validated questionnaire on symptoms, Schirmer I, Jones test, Ferning test, BUT, corneal aesthesiometry, tear clearance test, lissamine green staining, impression conjunctival cytology. Data were statistically evaluated and sensitivity, specificity, likelihood ratio (LR+), receiver-operating characteristics (ROC) curves were calculated for each test. RESULTS Data showed a poor diagnostic performance of Schirmer test I (sensitivity 0.42; specificity 0.76; LR+1.75) and BUT (sensitivity 0.92; specificity 0.17; LR+1.11) (area under the curve in ROC analysis <0.58). Validated subjective symptoms questionnaire (sensitivity 0.89; specificity 0.72; LR+3.18), Jones test (sensitivity 0.60; specificity 0.88; LR+5), corneal aesthesiometry (sensitivity 0.80; specificity 0.67; LR+2.42), and tear clearance test (sensitivity 0.63; specificity 0.84; LR+3.93), all exhibited a high diagnostic performance (area under the curve in the ROC analysis always >0.70). Lissamine green staining exhibited the best performance (sensitivity 0.63; specificity 0.89; LR+5.72) but the result could be distorted by an incorporation bias. CONCLUSIONS Our data suggest to implement the items for ocular signs and symptoms contained in many SS-I diagnostic criteria with the use of a validated questionnaire, performance of Jones test, corneal aesthesiometry measurement, and tear clearance rate evaluation.
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Affiliation(s)
- P Versura
- Department of Surgical Science and Transplants, Sect. Ophthalmology, Alma Mater Studiorum Università di Bologna, Bologna, Italy.
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