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Colijn JM, den Hollander AI, Demirkan A, Cougnard-Grégoire A, Verzijden T, Kersten E, Meester-Smoor MA, Merle BMJ, Papageorgiou G, Ahmad S, Mulder MT, Costa MA, Benlian P, Bertelsen G, Bron AM, Claes B, Creuzot-Garcher C, Erke MG, Fauser S, Foster PJ, Hammond CJ, Hense HW, Hoyng CB, Khawaja AP, Korobelnik JF, Piermarocchi S, Segato T, Silva R, Souied EH, Williams KM, van Duijn CM, Delcourt C, Klaver CCW. Increased High-Density Lipoprotein Levels Associated with Age-Related Macular Degeneration: Evidence from the EYE-RISK and European Eye Epidemiology Consortia. Ophthalmology 2019; 126:393-406. [PMID: 30315903 DOI: 10.1016/j.ophtha.2018.09.045] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 09/01/2018] [Accepted: 09/11/2018] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Genetic and epidemiologic studies have shown that lipid genes and high-density lipoproteins (HDLs) are implicated in age-related macular degeneration (AMD). We studied circulating lipid levels in relationship to AMD in a large European dataset. DESIGN Pooled analysis of cross-sectional data. PARTICIPANTS Individuals (N = 30 953) aged 50 years or older participating in the European Eye Epidemiology (E3) consortium and 1530 individuals from the Rotterdam Study with lipid subfraction data. METHODS AMD features were graded on fundus photographs using the Rotterdam classification. Routine blood lipid measurements, genetics, medication, and potential confounders were extracted from the E3 database. In a subgroup of the Rotterdam Study, lipid subfractions were identified by the Nightingale biomarker platform. Random-intercepts mixed-effects models incorporating confounders and study site as a random effect were used to estimate associations. MAIN OUTCOME MEASURES AMD features and stage; lipid measurements. RESULTS HDL was associated with an increased risk of AMD (odds ratio [OR], 1.21 per 1-mmol/l increase; 95% confidence interval [CI], 1.14-1.29), whereas triglycerides were associated with a decreased risk (OR, 0.94 per 1-mmol/l increase; 95% CI, 0.91-0.97). Both were associated with drusen size. Higher HDL raised the odds of larger drusen, whereas higher triglycerides decreases the odds. LDL cholesterol reached statistical significance only in the association with early AMD (P = 0.045). Regarding lipid subfractions, the concentration of extra-large HDL particles showed the most prominent association with AMD (OR, 1.24; 95% CI, 1.10-1.40). The cholesteryl ester transfer protein risk variant (rs17231506) for AMD was in line with increased HDL levels (P = 7.7 × 10-7), but lipase C risk variants (rs2043085, rs2070895) were associated in an opposite way (P = 1.0 × 10-6 and P = 1.6 × 10-4). CONCLUSIONS Our study suggested that HDL cholesterol is associated with increased risk of AMD and that triglycerides are negatively associated. Both show the strongest association with early AMD and drusen. Extra-large HDL subfractions seem to be drivers in the relationship with AMD, and variants in lipid genes play a more ambiguous role in this association. Whether systemic lipids directly influence AMD or represent lipid metabolism in the retina remains to be answered.
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Affiliation(s)
- Johanna M Colijn
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Anneke I den Hollander
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ayse Demirkan
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Audrey Cougnard-Grégoire
- Bordeaux Population Health Research Center, UMR 1219, University of Bordeaux, Inserm, Bordeaux, France
| | - Timo Verzijden
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Eveline Kersten
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Magda A Meester-Smoor
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Benedicte M J Merle
- Bordeaux Population Health Research Center, UMR 1219, University of Bordeaux, Inserm, Bordeaux, France
| | - Grigorios Papageorgiou
- Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Shahzad Ahmad
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Monique T Mulder
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Miguel Angelo Costa
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
| | - Pascale Benlian
- Univ. Lille, CHU Lille, UMR 8199 - EGID - European Genomic Institute for Diabetes, Lille, France
| | - Geir Bertelsen
- Department of Community Medicine, UiT, The Arctic University of Norway, Tromsø, Norway; Department of Ophthalmology, University Hospital of North Norway, Tromsø, Norway
| | - Alain M Bron
- Department of Ophthalmology, University Hospital, Eye and Nutrition Research Group, Dijon, France
| | - Birte Claes
- Institute of Epidemiology and Social Medicine, University of Muenster, Germany
| | | | - Maja Gran Erke
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Sascha Fauser
- Department of Ophthalmology, University Hospital Cologne, Cologne, Germany; Hoffmann-La Roche AG, Basel, Switzerland
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; Integrative Epidemiology, UCL Institute of Ophthalmology, London, United Kingdom
| | - Christopher J Hammond
- Section of Academic Ophthalmology, School of Life Course Sciences, King's College London, St. Thomas' Hospital, London, United Kingdom; Department of Twin Research & Genetic Epidemiology, King's College London, St. Thomas' Hospital, London, United Kingdom
| | - Hans-Werner Hense
- Institute of Epidemiology and Social Medicine, University of Muenster, Germany
| | - Carel B Hoyng
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Jean-Francois Korobelnik
- Bordeaux Population Health Research Center, UMR 1219, University of Bordeaux, Inserm, Bordeaux, France; Service d'Ophtalmologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | | | - Tatiana Segato
- Department of Ophthalmology, University of Padova, Padova, Italy
| | - Rufino Silva
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal; Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Eric H Souied
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, University Paris Est Creteil, Creteil, France
| | - Katie M Williams
- Section of Academic Ophthalmology, School of Life Course Sciences, King's College London, St. Thomas' Hospital, London, United Kingdom; Department of Twin Research & Genetic Epidemiology, King's College London, St. Thomas' Hospital, London, United Kingdom
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Cécile Delcourt
- Bordeaux Population Health Research Center, UMR 1219, University of Bordeaux, Inserm, Bordeaux, France
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
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Piermarocchi S, Sartore M, Lo Giudice G, Monterosso G, Pilotto E, Segato T. Is There any Relationship between Photodynamic Therapy for Exudative Age-Related Macular Degeneration and Choroidal Neovascularization Recurrence? A Rationale for Combined Treatments. Eur J Ophthalmol 2018; 16:686-94. [PMID: 17061219 DOI: 10.1177/112067210601600505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose Photodynamic therapy (PDT) is the treatment of choice for subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (ARMD). Interpretation of PDT mechanism of action is not yet fully understood and causes of CNV recurrences are unclear. The authors have conducted a retrospective analysis of fluorescein and indocyanine green angiographies in patients treated with multiple PDT in order to identify risk factors for recurrence. Methods A total of 342 eyes of 342 patients (207 women and 135 men) with ARMD and subfoveal CNV were treated with at least two PDT. Angiographic (fluorescein and indocyanine green) features of recurrences were confronted to pretreatment examinations in all patients. RESULTS. Post-PDT angiographies showed in all eyes a dark circle corresponding to the laser spot even 1 year after treatment. Persistence or progressive regrowth of CNV developed in an area adjacent or corresponding to the original lesion, without any specific relationship with the location of fluorescein and indocyanine green late leakage or with presence of abnormal fluorescence due to pigment abnormalities. At the 3-month angiographic follow-up, 23 patients (6.7%) showed a recurrent CNV resembling shape and dimension of the laser spot used for the PDT treatment. Conclusions The authors failed to identify angiographic signs helpful to predict the risk of CNV persistence or recurrence. PDT leaves minor but persistent changes in the choroidal vasculature within the treatment area. In some cases, the recurrent CNV seems to be related to the laser spot of the PDT.
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Affiliation(s)
- S Piermarocchi
- Department of Ophthalmology, University of Padova, Italy.
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Colijn JM, Buitendijk GHS, Prokofyeva E, Alves D, Cachulo ML, Khawaja AP, Cougnard-Gregoire A, Merle BMJ, Korb C, Erke MG, Bron A, Anastasopoulos E, Meester-Smoor MA, Segato T, Piermarocchi S, de Jong PTVM, Vingerling JR, Topouzis F, Creuzot-Garcher C, Bertelsen G, Pfeiffer N, Fletcher AE, Foster PJ, Silva R, Korobelnik JF, Delcourt C, Klaver CCW. Prevalence of Age-Related Macular Degeneration in Europe: The Past and the Future. Ophthalmology 2017; 124:1753-1763. [PMID: 28712657 PMCID: PMC5755466 DOI: 10.1016/j.ophtha.2017.05.035] [Citation(s) in RCA: 287] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 05/02/2017] [Accepted: 05/26/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose Age-related macular degeneration (AMD) is a frequent, complex disorder in elderly of European ancestry. Risk profiles and treatment options have changed considerably over the years, which may have affected disease prevalence and outcome. We determined the prevalence of early and late AMD in Europe from 1990 to 2013 using the European Eye Epidemiology (E3) consortium, and made projections for the future. Design Meta-analysis of prevalence data. Participants A total of 42 080 individuals 40 years of age and older participating in 14 population-based cohorts from 10 countries in Europe. Methods AMD was diagnosed based on fundus photographs using the Rotterdam Classification. Prevalence of early and late AMD was calculated using random-effects meta-analysis stratified for age, birth cohort, gender, geographic region, and time period of the study. Best-corrected visual acuity (BCVA) was compared between late AMD subtypes; geographic atrophy (GA) and choroidal neovascularization (CNV). Main Outcome Measures Prevalence of early and late AMD, BCVA, and number of AMD cases. Results Prevalence of early AMD increased from 3.5% (95% confidence interval [CI] 2.1%–5.0%) in those aged 55–59 years to 17.6% (95% CI 13.6%–21.5%) in those aged ≥85 years; for late AMD these figures were 0.1% (95% CI 0.04%–0.3%) and 9.8% (95% CI 6.3%–13.3%), respectively. We observed a decreasing prevalence of late AMD after 2006, which became most prominent after age 70. Prevalences were similar for gender across all age groups except for late AMD in the oldest age category, and a trend was found showing a higher prevalence of CNV in Northern Europe. After 2006, fewer eyes and fewer ≥80-year-old subjects with CNV were visually impaired (P = 0.016). Projections of AMD showed an almost doubling of affected persons despite a decreasing prevalence. By 2040, the number of individuals in Europe with early AMD will range between 14.9 and 21.5 million, and for late AMD between 3.9 and 4.8 million. Conclusion We observed a decreasing prevalence of AMD and an improvement in visual acuity in CNV occuring over the past 2 decades in Europe. Healthier lifestyles and implementation of anti–vascular endothelial growth factor treatment are the most likely explanations. Nevertheless, the numbers of affected subjects will increase considerably in the next 2 decades. AMD continues to remain a significant public health problem among Europeans.
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Affiliation(s)
- Johanna M Colijn
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Gabriëlle H S Buitendijk
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Elena Prokofyeva
- Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium; Federal Agency for Medicines and Health Products, Brussels, Belgium
| | - Dalila Alves
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
| | - Maria L Cachulo
- Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal; Department of Ophthalmology, Coimbra Hospital and University Center (CHUC), Coimbra, Portugal; Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
| | - Anthony P Khawaja
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Audrey Cougnard-Gregoire
- University Bordeaux, Inserm, Bordeaux Population Health Research Center, Team LEHA, Bordeaux, France
| | - Bénédicte M J Merle
- University Bordeaux, Inserm, Bordeaux Population Health Research Center, Team LEHA, Bordeaux, France
| | - Christina Korb
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - Maja G Erke
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Alain Bron
- Department of Ophthalmology, University Hospital, Eye and Nutrition Research Group, Dijon, France
| | | | - Magda A Meester-Smoor
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Tatiana Segato
- Department of Ophthalmology, University of Padova, Padova, Italy
| | | | - Paulus T V M de Jong
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Institute of Neurosciences (NIN), Institute of the Royal Netherlands Academy of Arts and Sciences (KNAW), Department of Ophthalmology, AMC, Amsterdam and LUMC, Leiden, Netherlands
| | | | - Fotis Topouzis
- Department of Ophthalmology, Aristotle University of Thessaloniki AHEPA Hospital, Thessaloniki, Greece
| | | | - Geir Bertelsen
- UiT The Arctic University of Norway/University Hospital of North Norway, Tromsø, Norway
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - Astrid E Fletcher
- Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; Integrative Epidemiology, UCL Institute of Ophthalmology, London, United Kingdom
| | - Rufino Silva
- Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal; Department of Ophthalmology, Coimbra Hospital and University Center (CHUC), Coimbra, Portugal; Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
| | - Jean-François Korobelnik
- University Bordeaux, Inserm, Bordeaux Population Health Research Center, Team LEHA, Bordeaux, France; CHU de Bordeaux, Service d'Ophtalmologie, Bordeaux, France
| | - Cécile Delcourt
- University Bordeaux, Inserm, Bordeaux Population Health Research Center, Team LEHA, Bordeaux, France
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands; Department of Ophthalmology, Radboud University Medical Center, Nijmegen, Netherlands.
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Piermarocchi S, Tognetto D, Piermarocchi R, Masetto M, Monterosso G, Segato T, Cavarzeran F, Turrini A, Peto T. Risk Factors and Age-Related Macular Degeneration in a Mediterranean-Basin Population: The PAMDI (Prevalence of Age-Related Macular Degeneration in Italy) Study - Report 2. Ophthalmic Res 2015; 55:111-8. [DOI: 10.1159/000441795] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 10/19/2015] [Indexed: 11/19/2022]
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Piermarocchi S, Miotto S, Colavito D, Leon A, Segato T. Combined effects of genetic and non-genetic risk factors affect response to ranibizumab in exudative age-related macular degeneration. Acta Ophthalmol 2015; 93:e451-7. [PMID: 25402348 DOI: 10.1111/aos.12587] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 10/06/2014] [Indexed: 01/14/2023]
Abstract
PURPOSE To investigate whether genetic and non-genetic risk factors influence 12-month response to ranibizumab treatment for exudative age-related macular degeneration (AMD). METHODS A cohort of 94 Caucasian patients with unilateral exudative AMD received intravitreal ranibizumab. After a three-injection loading phase, a PRN regimen was followed. Patients were genotyped for three single-nucleotide polymorphisms: CFH rs1061170, ARMS2 rs10490924 and C3 rs2230199. Non-genetic risk factors [choroidal neovascularization (CNV) phenotype, smoking habit, hypertension and body mass index] were considered. The selected end-point was the 12-month variation of number of ETDRS letters. RESULTS Complement factor H (CFH) risk alleles, smoking history and arterial hypertension each independently influenced treatment response, with worse 12-month BCVA outcomes (p = 0.036, 0.037, 0.043, respectively). A significant cumulative effect of these risk factors was also observed: patients homozygous for the CFH risk alleles and with a positive smoking history showed a mean loss of 8.0 ETDRS letters (p = 0.010). Patients with CFH risk alleles, smoking history and hypertension had a mean loss of 13.9 ETDRS letters (p = 0.013). CNV phenotypes did not influence visual outcomes, nor were they associated with other genetic/non-genetic risk factors. CONCLUSIONS Complement factor H risk alleles, smoking history and hypertension affect the mid-term response to ranibizumab in exudative AMD.
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Affiliation(s)
| | | | | | | | - Tatiana Segato
- Neuroscience Department; University of Padova; Padova Italy
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Piermarocchi S, Segato T, Scopa P, Masetto M, Ceca S, Cavarzeran F, Peto T. The prevalence of age-related macular degeneration in Italy (PAMDI) study: report 1. Ophthalmic Epidemiol 2011; 18:129-36. [PMID: 21609241 DOI: 10.3109/09286586.2011.574334] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The present study aimed to estimate prevalence and risk factors associated with age-related macular degeneration (ARMD) in an Italian population and to analyze differences between urban and rural communities. METHODS We conducted a population-based cross-sectional study among elderly residents in Northeast Italy. Participants were divided into urban and rural groups based on whether they lived in the city of Padova or the villages of Teolo and Torreglia, respectively. Fundus photographs were graded according to the International Classification for Age-related Maculopathy. RESULTS A total of 1162 randomly selected subjects aged 61 years or more were invited to participate in the study. We examined 885 subjects, and 845 were eligible for fundus photograph grading. ARMD was estimated to affect 62.7% of the whole population (drusen 63-124 μm = 48.3%; drusen ≥125 μm = 10.4%; advanced ARMD = 4.1%). Age was confirmed as a risk factor for drusen ≥125 μm and advanced ARMD (Odds Ratio [OR] = 1.47, 95% Confidence Interval [CI] 1.28-1.69 and OR = 1.62, 95% CI 1.28-2.05, respectively, for a 5-year increase in age). The rural group appeared to be at a higher risk of developing large drusen compared to the urban sample (OR = 1.61, 95% CI 1.01-2.63) when adjusting for age and gender. CONCLUSIONS The results confirmed that ARMD affects a high percentage of the elderly population in Italy. This study does not support the hypothesis that living in a rural environment or belonging to a population of the Mediterranean basin may be protective against the intermediate stages of the disease.
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Vandendael I, Steenhaut O, Hubin A, Vereecken J, Prince P, Reniers F, Segato T. AES analysis of nitride layers on steel with target factor analysis. SURF INTERFACE ANAL 2004. [DOI: 10.1002/sia.1848] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Midena E, Pilotto E, de Belvis V, Zaltron S, Doro D, Segato T, Piermarocchi S. Choroidal vascular changes after transpupillary thermotherapy for choroidal melanoma. Ophthalmology 2003; 110:2216-22. [PMID: 14597533 DOI: 10.1016/s0161-6420(03)00715-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [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: 11/29/2022] Open
Abstract
OBJECTIVE To evaluate choroidal vascular alterations after transpupillary thermotherapy used as the sole treatment for choroidal melanoma. DESIGN Prospective noncomparative interventional case series. PARTICIPANTS Forty-five eyes of 45 patients affected by malignant choroidal melanoma treated with transpupillary thermotherapy alone with more than 1 year of follow-up. INTERVENTION Transpupillary thermotherapy was performed through a panfunduscopic contact lens using an 810-nm diode laser. MAIN OUTCOME MEASURES Dynamic/static fluorescein and indocyanine green angiography were performed at scheduled intervals (24 hours, at 3-month intervals during the first year, and every 6 months thereafter) after transpupillary thermotherapy. Visual acuity, clinical evaluation, fundus photographs, and ultrasonographic examination were also performed. RESULTS The mean follow-up was 30.5 months (range, 12-54 months). Changes in the choroidal circulation were always confined within the treatment margins (except in one case) and characterized by occlusion of choriocapillaris (100%), patent medium and/or large choroidal vessels (76%), retinochoroidal anastomosis (11%), and progressive choroidal vascular remodeling (42%). Forty-one cases (91%) showed persistent clinical regression, and four cases (9%) recurred; recurrent cases showed retinochoroidal anastomosis. CONCLUSIONS Transpupillary thermotherapy is suggested as a new single therapeutic modality in the treatment of selected choroidal melanomas, but more precise eligibility criteria and longer follow-up are mandatory. Patent choroidal circulation, choroidal vascular remodeling, and anastomosis after transpupillary thermotherapy might be helpful to detect recurrent tumors.
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Affiliation(s)
- Edoardo Midena
- Department of Ophthalmology, University of Padova, Padova, Italy.
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Piermarocchi S, Lo Giudice G, Sartore M, Friede F, Segato T, Pilotto E, Midena E. Photodynamic therapy increases the eligibility for feeder vessel treatment of choroidal neovascularization caused by age-related macular degeneration. Am J Ophthalmol 2002; 133:572-5. [PMID: 11931801 DOI: 10.1016/s0002-9394(01)01370-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [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: 11/23/2022]
Abstract
PURPOSE To report angiographic observations about feeder vessel identification after photodynamic therapy in patients with choroidal neovascularization caused by age-related macular degeneration. DESIGN Cohort study. METHODS We analyzed fluorescein and indocyanine green dynamic angiography in 156 eyes of 145 patients before and after photodynamic therapy to identify the feeder vessels of the choroidal neovascular membrane. RESULTS Before photodynamic therapy one or more feeder vessel could be detected in 35 (22.4%) out of 156 eyes with choroidal neovascularization. Three months after photodynamic therapy, a feeder vessel could be identified in 112 (84.2%) out of 133 eyes with persistent choroidal neovascularization. Among these, 16 eyes received direct laser photocoagulation of the feeder vessel and did not need any further photodynamic therapy. CONCLUSION Previous photodynamic therapy improves the detection of the feeder vessel of the choroidal neovascularization. A sequential combined therapy (photodynamic and feeder vessel treatment) could be considered as an alternative to multiple photodynamic treatments.
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Degli C, Blarzino MC, Valenti M, Segato T, Mideno E. Macular function impairment in eyes with early age-related macular degeneration. Am J Ophthalmol 1997. [DOI: 10.1016/s0002-9394(14)71163-8] [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: 11/17/2022]
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Midena E, Degli Angeli C, Blarzino MC, Valenti M, Segato T. Macular function impairment in eyes with early age-related macular degeneration. Invest Ophthalmol Vis Sci 1997; 38:469-77. [PMID: 9040480] [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: 02/03/2023] Open
Abstract
PURPOSE To study different aspects of macular function in eyes with early age-related macular degeneration (early AMD: drusen with or without retinal pigment epithelium alterations) and normal visual acuity, to obtain a complete evaluation of macular function impairment in early AMD and to study the relationship between macular function and the ophthalmoscopic signs of early AMD. METHODS Forty-seven subjects with early AMD and visual acuity better than 20/25 in at least one eye were studied: 34 patients had bilateral early AMD (group 1), 13 had neovascular AMD in the fellow (nonstudy) eye (group 2). Thirty-six age-matched healthy subjects were used as controls. Thirty degree stereoscopic fundus photographs and fluorescein angiography were performed to grade macular lesions. Macular recovery function, central visual field sensitivity, spatiotemporal contrast sensitivity, and the Farnsworth-Munsell 100 hue test were used to study different aspects of macular function. RESULTS Except for color vision, all macular function tests were significantly impaired in eyes of patients with early AMD compared to those in control subjects. No functional difference was found between groups 1 and 2. The increase in drusen number negatively influenced macular recovery function. Increasing drusen confluence reduced macular recovery function as well as central visual field sensitivity and some selected spatial frequencies of spatiotemporal contrast sensitivity. Geographic atrophy of the retinal pigment epithelium and focal hyperpigmentation reduced macular recovery function and contrast sensitivity at the highest spatial frequency. CONCLUSIONS Macular recovery function central visual field sensitivity, and spatiotemporal contrast sensitivity are adequate and reliable indicators of macular function impairment in early AMD. Macular recovery function is the test that best reflects the ophthalmoscopic characteristics of early AMD because its deterioration parallels the worsening of typical fundus lesions. Function tests are valuable in the evaluation of patients with early AMD, particularly when interventional trials are planned.
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Affiliation(s)
- E Midena
- Institute of Ophthalmology, University of Padova, Italy
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Abstract
BACKGROUND The effect of external beam radiation therapy (teletherapy) on the choroidal circulation is poorly known. Eyes irradiated with teletherapy represent a good model to study, without confounding factors, the pathophysiologic and clinical aspects of radiation-induced chorioretinal damage. This study used fluorescein and indocyanine green choroidal angiography to investigate the late effects of external eye irradiation on the choroidal circulation. METHODS Fluorescein angiography and indocyanine green choroidal videoangiography were performed on patients with radiation retinopathy because of external eye irradiation for orbital and paranasal sinus malignancies. Patients were divided into two groups according to the treatment field (anterior unilateral or bilateral). RESULTS Indocyanine green angiograms showed areas of choriocapillaris hypoperfusion in all eyes-unilateral or bilateral irradiation-affected by radiation retinopathy. Late indocyanine green choroidal staining was found in five eyes (28%) of the patients who received unilateral anterior irradiation. In the same group, nine eyes (52%) had signs of choroidal precapillary occlusion and four eyes (23%) had rubeosis iridis without retinal neovascularization. One case of subfoveal choroidal neovascularization was documented in the bilateral irradiation group. CONCLUSIONS Radiation side effects are not limited to the retinal vessels but also involve choroidal circulation. The damage to the choroid is primarily vascular, and its clinical aspects depend on the treatment fields. Anterior irradiation may be a critical factor for the appearance of unusual rubeosis iridis and neovascular glaucoma.
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Affiliation(s)
- E Midena
- Institute of Ophthalmology, University of Padova, Italy
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13
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Abstract
Macular drusen are one of the earliest signs of age-related macular degeneration but little information is available on the functional aspects of macular area in patients with drusen. To determine if drusen are associated with changes in central visual field sensitivity, one eye of each of 35 subjects (mean age 64.9 years) with bilateral drusen and visual acuity of 1.0 (20/20) underwent automated static threshold perimetry of the central 10 degrees. 16 normal subjects (mean age 65.8 years) were used as controls. 30 degrees fundus photographs were graded in a masked fashion for the clinical characteristics of drusen: type, size and number. The mean sensitivity (MS) of the central 10 degrees was significantly lower in eyes with drusen compared to normal eyes (p = .0001). After grading drusen eyes for size (> or = 63 mu) and type (presence of soft drusen), MS significantly deteriorated when large and soft drusen were present. These results suggest that central visual field sensitivity is precociously affected in eyes with drusen and that testing central visual field sensitivity may be useful as functional parameter in long term studies on the evolution of age-related macular degeneration.
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Affiliation(s)
- E Midena
- Institute of Ophthalmology, University of Padova, Italy
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14
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Abstract
Age-related macular degeneration (AMD), a bilateral, progressive macular disease, represents the major cause of blindness among elderly people living in Western countries. Clinical features of AMD vary from the initial asymptomatic aspects, drusen and retinal pigment epithelium alterations, to severe atrophic or exudative changes in the advanced stages, characterized by the irreversible decrease of visual function. Current epidemiologic, pathogenetic and clinical data are reviewed, and the importance of the exact identification of patients at risk of evolution toward the exudative form is addressed. The therapeutic approach to AMD is also analyzed and the role of laser photocoagulation is discussed.
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Affiliation(s)
- T Segato
- Institute of Ophthalmology, University of Padova, Italy
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15
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Midena E, Segato T, Bottin G, Piermarocchi S, Fregona I. The effect on the macular function of laser photocoagulation for diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 1992; 230:162-5. [PMID: 1577298 DOI: 10.1007/bf00164656] [Citation(s) in RCA: 16] [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: 12/27/2022] Open
Abstract
The benefit of focal and grid-laser photocoagulation in reducing the risk of visual loss from diabetic macular edema has been established. In order to investigate the effect of this treatment on macular function, 30 diabetics with macular edema and 1.0 visual acuity were tested before and after laser treatment at intervals of 1 week, and 1 and 3 months, respectively. The test was carried out by means of nyctometry, contrast sensitivity, hue discrimination and critical flicker frequency of blue cones. All patients had abnormal results in macular tests before treatment. During the follow-up, visual acuity remained stable and the macular tests did not statistically modify, except for nyctometry, which deteriorated at the 1-week follow-up (P = 0.02) and then increased to the basal values, and contrast sensitivity [improved at the last control (P = 0.006)]. Clinical regression of macular edema was observed, but macular function tests never normalized. Patients with diabetic macular edema and good visual acuity should be monitored with many functional methods, and laser treatment should be performed before macular function deteriorates irreversibly.
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Affiliation(s)
- E Midena
- Institute of Ophthalmology, University of Padova, Italy
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16
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Segato T, Midena E, Grigoletto F, Zucchetto M, Fedele D, Piermarocchi S, Crepaldi G. The epidemiology and prevalence of diabetic retinopathy in the Veneto region of north east Italy. Veneto Group for Diabetic Retinopathy. Diabet Med 1991; 8 Spec No:S11-6. [PMID: 1825948 DOI: 10.1111/j.1464-5491.1991.tb02149.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.2] [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] [Indexed: 12/28/2022]
Abstract
The prevalence of diabetic retinopathy and its relationship to a number of risk factors were examined in a population-based study in the Veneto region of North East Italy. Of 1321 diabetic patients selected, 98% attended for examination. Prevalence of diabetic retinopathy was 26.2% (24.4% background and 1.8% proliferative). The prevalence of retinopathy was significantly related (p less than 0.01) to the duration of diabetes (17.3% for less than 5 years; 60.8% for greater than 20 years). Proliferative retinopathy was much more prevalent after 20 years of diabetes. After 10 years most proliferative retinopathy was found in Type 1 diabetic patients, but before 10 years from diagnosis it was most prevalent in Type 2 diabetes. The prevalence of retinopathy was significantly related (p less than 0.001) to the type of diabetes and was found predominantly in Type 1 (46.2%) and insulin-treated Type 2 (45.9%) subjects and to a lesser degree in non-insulin-treated patients (24.6%). The prevalence of retinopathy was significantly related to both fasting and post-prandial blood glucose levels (p less than 0.001), blood urea nitrogen (p less than 0.05), and systolic (p less than 0.001) and diastolic (p less than 0.01) blood pressure. No significant differences were found in the prevalence of total or proliferative retinopathy between males and females. No significant relationships were found with family history of diabetes, alcohol intake, smoking habits, cholesterol, triglycerides, and serum uric acid.
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Affiliation(s)
- T Segato
- Institute of Ophthalmology, University of Padova, Italy
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17
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Abstract
In order to identify early and late modifications induced by ionizing radiation on the conjunctival surface, we studied 10 patients irradiated for paranasal sinus tumors. A clinical and morphological study of conjunctival epithelium (using an impression cytology technique) was performed; 5 patients were examined during and the others after treatment. Actinic conjunctivitis and keratitis, observed during treatment, reappeared within a few months after the end of radiotherapy. At a threshold dose of 25 Gy, chronic nuclear changes and cellular surface disorganization of the conjunctival epithelium were found--these progressed and persisted. Our data support the importance of careful monitoring of such irradiated patients and the benefit of planning a prospective clinical study to evaluate the effects of available drugs (all-trans retinoic acid) in the treatment of these lesions.
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Affiliation(s)
- E Midena
- Institute of Ophthalmology, University of Padova, Italy
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18
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Piermarocchi S, Segato T, Bertoja H, Midena E, Zucchetto M, Girolami A, Procidano M, Mares M. Branch retinal vein occlusion: the pathogenetic role of blood viscosity. Ann Ophthalmol 1990; 22:303-11. [PMID: 2221710] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The pathogenesis of branch retinal vein occlusion has not been completely clarified. The role of abnormal blood viscosity in the appearance and evolution of the disease has recently been advocated. We studied 54 patients with long-standing branch retinal vein occlusion from a hemorrheologic point of view. Depending on the extension of retinal ischemia, two subgroups were identified. Hematocrit, blood and plasma viscosity, whole blood filterability, cell deformability, and fibrinogen levels were investigated. Thirty-five subjects of similar age, sex, and risk factors of diabetes and hypertension served as controls. Our results showed that blood viscosity is higher in patients with occlusion and particularly in those with severe retinal ischemia. Statistical analysis showed a direct correlation between blood viscosity and hematocrit.
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19
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Abstract
Nyctometry was used to assess macular recovery function in 234 diabetic patients; their retinopathy ranged from no retinopathy (99) to early background retinopathy (135). None had visual symptoms or macular oedema. Abnormal (reduced) nyctometry findings were significantly and directly related to the deterioration of diabetic retinopathy. There was no significant association between reduced or normal nyctometry findings and glycaemia at the time of the examination. The value of nyctometry in screening and follow-up is discussed.
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Affiliation(s)
- E Midena
- Institute of Ophthalmology, Retinal Vascular Clinic, University of Padova, Italy
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20
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Midena E, Segato T, Giuliano M. Do oscillatory potentials and macular recovery time reflect metabolic control of diabetes mellitus? Ophthalmology 1989; 96:1274-6. [PMID: 2619814 DOI: 10.1016/s0161-6420(89)32952-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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21
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Midena E, Segato T, Radin S, di Giorgio G, Meneghini F, Piermarocchi S, Belloni AS. Studies on the retina of the diabetic db/db mouse. I. Endothelial cell-pericyte ratio. Ophthalmic Res 1989; 21:106-11. [PMID: 2734001 DOI: 10.1159/000266787] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.5] [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: 01/02/2023]
Abstract
The genetically diabetic db/db mouse is a model of type-2 diabetes, where nephropathy and neuropathy, but not retinopathy were observed. The authors studied the retinas (trypsin digestion technique) of 16 db/db mice and 16 age-matched litter mates (db/m; controls), divided into five age groups. They noted a marked increase in the ratio of endothelial cells to intramural pericytes in diabetic mice compared to controls. This increase resulted from a selective and highly significant loss of pericytes in db/db mice (p less than 0.05). Some strand-like and relatively acellular capillaries were also observed. The db/db mouse may represent an adequate model for studies on the pathogenesis of retinopathy.
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Affiliation(s)
- E Midena
- Institute of Ophthalmology, University of Padova, Italy
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22
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Briani G, Riva F, Midena E, Trevisan R, Sgnaolin E, Jori E, Munari R, Bruttomesso D, Segato T, Tiengo A. Prevalence of microangiopathic complications in hyperglycemia secondary to pancreatic disease. J Diabet Complications 1988; 2:50-2. [PMID: 2968358 DOI: 10.1016/0891-6632(88)90030-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Diabetes secondary to pancreatic disease (PD) represents a useful model for the study of the effects of chronic hyperglycemia on microangiopathic complications in the absence of those genetic factors predisposing to Type I diabetes. Our aim was to evaluate the prevalence of nephropathy and retinopathy in a group of 86 patients with PD. The genetic pattern, assessed by the determination of HLA antigens, was different than in patients with Type I diabetes. A family history of diabetes was present in 53% of the patients. The prevalence of retinopathy was 37%. Eighteen percent of the patients with duration of diabetes less than 10 years showed an albumin excretion rate (AER) greater than 40 mg/24 hr. The prevalence of pathologic microalbuminuria (greater than 40 mg/24 hr) was found in 29% of the patients with duration of diabetes greater than 10 years. The prevalence of pathologic microalbuminuria is related to the duration of diabetes. Both diastolic and systolic blood pressure is positively correlated to albumin excretion rate (p less than 0.02), suggesting a possible role of hypertension in the evolution of nephropathy. Sixty-one percent of the patients with AER greater than 40 mg/24 h had retinopathy, thus confirming the close association between renal and ocular complications. Abnormal microalbuminuria and retinopathy were not influenced by a family history of diabetes. We conclude that the prevalence of microangiopathic complications is similar to that seen in Type I diabetes, and the metabolic abnormalities of diabetes can play a direct role in the development of diabetic microangiopathy.
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Affiliation(s)
- G Briani
- Divisione Malattie del Ricambio, Policlinico, Padova, Italy
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23
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Abstract
Radiation retinopathy is a complication of the therapeutic irradiation of orbital and periorbital structures. The authors studied two groups of patients who had orbital (group 1) and periorbital (group 2) external irradiation. Radiation retinopathy occurred in 63.6% of patients in group 1 and 36.3% group 2. Retinal radiation damage showed a different clinical evaluation in the two groups, appearing earlier (mean, 11 versus 55 months) and with greater involvement of the peripheral retina in group 1 (with three cases of neovascular glaucoma). This study demonstrates that radiation retinopathy occurs in a significant number of cases when the eye is not totally involved in the irradiation field and shows at least two different clinical aspects in relation to the radiation treatment. It also suggests that portal design and choroidal circulation damage may represent important factors in the development of radiation retinopathy.
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Affiliation(s)
- E Midena
- Institute of Ophthalmology, University of Padova, Italy
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24
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25
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Abstract
When noninvasive techniques fail to confirm or rule out the suspicion of a malignant lesion, fine needle aspiration biopsy may provide an efficient, economical and relatively safe method of obtaining material for cytological study. The technique may also be valuable for intraoperative morphological evaluation. Traumatic complications produced by fine (21-25 gauge) needles are infrequent and almost never serious, and concerns about tumor seeding through the procedure have been largely dispelled by recent studies. Reliable results require a high level of skill in performing the aspiration procedure and in cytologically examining the small amount of material obtained. The authors review the history, applications, techniques and complications of fine needle aspiration biopsy, presenting guidelines for and illustrations of its use in specific ophthalmic situations.
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26
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27
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Tiengo A, Segato T, Briani G, Setti A, Del Prato S, Devidé A, Padovan D, Virgili F, Crepaldi G. The presence of retinopathy in patients with secondary diabetes following pancreatectomy or chronic pancreatitis. Diabetes Care 1983; 6:570-4. [PMID: 6653314 DOI: 10.2337/diacare.6.6.570] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The incidence of diabetic retinopathy was evaluated by means of fluorescein angiography in 54 patients with diabetes secondary to chronic pancreatitis or to pancreatectomy. Thirty-one percent of the patients had background retinopathy; none had proliferative retinopathy. The percentage of patients with retinopathy was the same in groups with or without a family history of diabetes. There was no correlation between the degree of metabolic control, the levels of C-peptide, glucagon, growth hormone, and the presence of retinopathy. Retinopathy was correlated with the duration of diabetes. In conclusion, diabetes caused by pancreatitis or pancreatectomy has a significant prevalence of retinopathy, which has more benign characteristics and slower evolution than the retinopathy in patients with primary diabetes.
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28
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Piermarocchi S, Corradini R, Midena E, Segato T. Correlation between retinal pigment epitheliitis and central serous chorioretinopathy. Ann Ophthalmol 1983; 15:425-8. [PMID: 6651152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A 37-year-old woman had sudden blurred vision in her right eye due to multifocal disturbances of the macular retinal pigment epithelium. Fluorescein angiography showed multiple pigment epithelial window defects with minimal late hyperfluorescence. The course of the disease, interpreted as retinal pigment epitheliitis, was complicated by a central serous chorioretinopathy. The possible relation between the two entities is discussed.
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29
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Segato T, Piermarocchi S, Midena E. Presumed ocular histoplasmosis in Europe: a case report. Ann Ophthalmol 1983; 15:354-6. [PMID: 6660707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A case of presumed ocular histoplasmosis was diagnosed in a diabetic patient, and an angiographic study of the ocular lesions was carried out. Results of histoplasmin skin test and the specific complement fixation test were negative. The epidemiologic aspects of histoplasmosis in Europe are considered.
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30
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Maggioni F, Trevisan C, Segato T, Zanchin G. [Case of Horton's arteritis with development of simultaneous bilateral amaurosis]. Riv Patol Nerv Ment 1983; 104:1-7. [PMID: 6678479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The Authors report a case of temporal arteritis which started with a sudden onset of bilateral amaurosis. They considered this case worth recording, on account of its unusual and striking way of manifestation. Moreover, the importance of an early diagnosis of the disease is underlined, since an adequate steroid therapy, carried out in time, often allows to avoid the serious complications which may arise, particularly blindness. Recent epidemiological studies which showed the elevated incidence of the disease in patients above the age of 50, underline the necessity of considering temporal arteritis as one of the diagnostical possibilities, even if the symptomatology is defective or unclear.
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31
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Segato T, Midena E, Piermarocchi S, Crepaldi G, Tiengo A. The effect of continuous subcutaneous insulin infusion treatment on proliferative diabetic retinopathy. Am J Ophthalmol 1982; 94:685-6. [PMID: 6756157 DOI: 10.1016/0002-9394(82)90023-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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32
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D'Ermo F, Secchi AG, Segato T, Mancini B, Fregona I. Immunopathology of the Lens. III. The effect of experimental allergic uveitis on the cation balance in the lens. Ophthalmologica 1978; 176:258-61. [PMID: 662277 DOI: 10.1159/000308719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Rabbit lenses from eyes suffering from experimental allergic uveitis showed a clear enhancement in the 86Rb efflux as compared to the lenses from the fellow normal eyes. Intracellular K+ was also significantly decreased and Na+ significantly increased after several relapses of inflammation.
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D'Ermo F, Secchi AG, Mancini B, Segato T, Fregona I. Immunopathology of the lens. II. 86Rb efflux and protein leakage from normal lenses exposed to antilens and antiuveoretina antibodies. Ophthalmologica 1978; 176:230-4. [PMID: 662274 DOI: 10.1159/000308743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Normal rabbit lenses exposed in vitro to heterologous antilens and antiuveoretina antibodies lose control of the intracellular 86Rb and this effect is followed by a late leakage of lenticular proteins; both phenomena take place only in the presence of complement. This antibody-induced complement-dependent membrane damage might be involved in the pathogenesis of complicated cataracts in uveitis and in the self-maintenance of recurrent uveal inflammations.
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34
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D'Ermo F, Secchi AG, Levi Minzi S, Segato T. Immunobiology of the lens. Experimental studies on lens cation and protein permeability in the presence of various antigen-antibody reactions. Folia Allergol (Roma) 1971; 18:496-510. [PMID: 5145445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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35
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Segato T, Levi-Minzi S. [Determination of the proteins in aqueous humor by means of ultraviolet spectrophotometry]. Minerva Oftalmol 1970; 12:168-9. [PMID: 5524038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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