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Arora S, Zur D, Iovino C, Chhablani J. Peripapillary fluid: Obvious and not so obvious! Surv Ophthalmol 2024; 69:311-329. [PMID: 38016521 DOI: 10.1016/j.survophthal.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/14/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023]
Abstract
Intraretinal or subretinal fluid in the peripapillary area can be clinically visualized in conditions such as peripapillary choroidal neovascularization, optic disc pit maculopathy, and optic nerve head tumors and granulomas. Optical coherence tomography (OCT) helps to visualize peripapillary fluid in many other chorioretinal conditions such as peripapillary pachychoroid syndrome, posterior uveitis, central retinal vein occlusion, malignant hypertension, hypotonic maculopathy as well as neuro-ophthalmological conditions such as glaucoma, microcystic macular edema and disc edema due papilledema, non-arteritic anterior ischemic optic neuropathy, neuroretinitis, and diabetic papillopathy. Often, the differential diagnosis of peripapillary fluid is a bit tricky and may lead to misdiagnosis and improper management. We describe a diagnostic algorithm for peripapillary fluid on OCT and outline the salient features and management of these conditions.
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Affiliation(s)
- Supriya Arora
- Bahamas Vision Centre and Princess Margaret Hospital, Nassau NP, Bahamas
| | - Dinah Zur
- Division of Ophthalmology, 26738 Tel Aviv Sourasky Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Claudio Iovino
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Jay Chhablani
- University of Pittsburgh, UPMC Eye Center, Pittsburgh, United States.
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Agarwal A, Menia NK, Markan A, Sallam AB, Habib A, Mansour A, Iovino C, Peiretti E, Demirel S, Tawfiq MA, Hanout M, Gupta V, Ghazi N, Sengupta S. Outcomes after giant peripheral retinotomy and anterior flap retinectomy for rhegmatogenous retinal detachments with advanced proliferative vitreoretinopathy using small gauge vitrectomy. Indian J Ophthalmol 2024:02223307-990000000-00174. [PMID: 38622862 DOI: 10.4103/ijo.ijo_2840_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/19/2024] [Indexed: 04/17/2024] Open
Abstract
PURPOSE To analyze the visual and anatomical outcomes for eyes with rhegmatogenous retinal detachment (RRD) and advanced proliferative vitreoretinopathy (PVR) undergoing giant peripheral retinotomy (GPR) using 25-gauge pars plana vitrectomy (PPV). METHODS In this retrospective multi-center study, patients with RRD with either anteroposterior or circumferential retinal shortening and advanced PVR requiring more than 90-degree GPR with/without relaxing retinotomy were included. Subjects of either gender, any age group, and with complete surgical notes were included. Outcome measures of the study included anatomical success (i.e. complete retinal re-attachment) at 6 months using survival analysis, visual outcomes, and post-operative complications. RESULTS Forty-one eyes of 41 patients (33 males) with a mean age of 44.9 ± 21.4 years were included. At 6 months follow-up, anatomical success was seen in 29 eyes (70.7%) with a cumulative re-attachment rate of 66% (95% confidence interval = 48 = 79%). All re-detachments occurred at ≤6 months with a peak at 4-6 months (n = 9). Twenty-three eyes (56%) achieved ambulatory vision (5/200) or better. Direct perfluorocarbon liquid-silicone oil exchange was performed in 20 eyes. Intra-operative complications included persistent retinal folds (2 eyes), subretinal air (1 eye), and subretinal bleed (1 eye). Eleven eyes (26.8%) developed secondary glaucoma (2 eyes required a drainage device), and hypotony of ≤6 mmHg was noted in 3 eyes (7.3%). Corneal decompensation was noted in 8 eyes (19.5%), and 3 eyes (7.3%) underwent re-surgery for re-RRD. CONCLUSION After GPR using small gauge PPV, two-thirds achieve anatomical success, and over half have ambulatory vision, but overall post-operative complications can occur in more than half of the eyes.
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Affiliation(s)
- Aniruddha Agarwal
- The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates (UAE)
- Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
- Department of Ophthalmology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Nitin Kumar Menia
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Jammu, India
| | - Ashish Markan
- Department of Ophthalmology, Eye7 Chaudhary Eye Center, New Delhi, India
| | - Ahmed B Sallam
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Ahmed Habib
- Department of Ophthalmology, Ain Shams University, Vitreoretinal Service, Al Mashreq Eye Hospital, Cairo, Egypt
| | - Ahmed Mansour
- Department of Ophthalmology, Ain Shams University, Vitreoretinal Service, Al Mashreq Eye Hospital, Cairo, Egypt
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Enrico Peiretti
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Sibel Demirel
- Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | | | - Mostafa Hanout
- Princess Margaret Cancer Center/University Health Network, Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, ON, Canada
| | - Vishali Gupta
- Advanced Eye Center, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Nicola Ghazi
- The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates (UAE)
- Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
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Gomel N, Goldstein M, Fung AT, Iovino C, Tatti F, Peiretti E, Habot-Wilner Z, Loewenstein A, Iglicki M, Zur D. Polypoidal Lesions Associated with Choroidal Nevi. Retina 2024:00006982-990000000-00639. [PMID: 38564803 DOI: 10.1097/iae.0000000000004112] [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: 04/04/2024]
Affiliation(s)
- Nir Gomel
- Ophthalmology Division, Tel Aviv Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michaella Goldstein
- Ophthalmology Division, Tel Aviv Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adrian T Fung
- Westmead and Central Clinical Schools, Specialty of Ophthalmology and Eye Health, The University of Sydney, Sydney, Australia
- Department of Ophthalmology, Faculty of Medicine, Health and Human Sciences, Macquarie University Hospital, Sydney, Australia
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Filippo Tatti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Zohar Habot-Wilner
- Ophthalmology Division, Tel Aviv Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Loewenstein
- Ophthalmology Division, Tel Aviv Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Matias Iglicki
- Private Retina Practice, University of Buenos Aires, Buenos Aires, Argentina
| | - Dinah Zur
- Ophthalmology Division, Tel Aviv Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Iovino C, Rosolia A, Marano E, Della Corte M, Testa F, Simonelli F. Navigated yellow subthreshold micropulse laser for refractory cystoid macular edema following rhegmatogenous retinal detachment surgery. Am J Ophthalmol Case Rep 2024; 33:101981. [PMID: 38274400 PMCID: PMC10809002 DOI: 10.1016/j.ajoc.2023.101981] [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: 04/15/2023] [Revised: 11/03/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024] Open
Abstract
Purpose To report the efficacy and safety of navigated 577nm yellow subthreshold micropulse laser (YSML) treatment in a case of refractory cystoid macular edema (CME) following combined phaco-vitrectomy for rhegmatogenous retinal detachment (RRD). Observations A 69-year-old male patient complained a slow and progressive visual loss in the right eye (RE) since two months. A complete ophthalmological evaluation was performed. Best corrected visual acuity (BCVA) was hand motion and slit lamp examination revealed a nuclear cataract and a total macula-off RRD in the RE. Patient underwent a combined phaco +25 gauge pars plana vitrectomy (PPV) with 5000 cSt silicon oil (SO) tamponade. At the 3-month follow up BCVA was 20/250, retina was completely flat but a macular proliferative vitreoretinopathy (PVR) was detected with swept source optical coherence tomography (SS-OCT) and a second 23 G PPV with PVR peeling and SO removal was performed. At 1 month visit from the second surgery retina was flat and BCVA was 20/200 due to a persistent CME. Oral carbonic anhydrase inhibitors and topical steroids were administered for 2 months without any improvements. At this point, YSML was applied with a macular grid pattern and at three months follow up visit SS-OCT showed a complete resolution of CME, BCVA was 20/100 and these anatomical and functional outcomes were maintained at 6 months follow-up. Conclusions and importance YSML treatment may be considered a safe and effective treatment strategy for the management of refractory CME following complex RRD surgery cases.
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Affiliation(s)
- Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Andrea Rosolia
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ernesto Marano
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Michele Della Corte
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Testa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
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Iovino C, Damiano L, Simonelli F, Sarraf D. Acute macular neuroretinopathy following uncomplicated epiretinal membrane removal. Can J Ophthalmol 2024:S0008-4182(24)00025-5. [PMID: 38346678 DOI: 10.1016/j.jcjo.2024.01.010] [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] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/17/2024] [Accepted: 01/24/2024] [Indexed: 02/24/2024]
Affiliation(s)
- Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Luciana Damiano
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - David Sarraf
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA; Greater Los Angeles Veterans Affairs Healthcare Center, Los Angeles, CA..
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Gomel N, Goldstein M, Fung AT, Iovino C, Tatti F, Peiretti E, Habot-Wilner Z, Loewenstein A, Iglicki M, Zur D. POLYPOIDAL LESIONS ASSOCIATED WITH CHOROIDAL NEVI. Retina 2024; 44:136-143. [PMID: 37748439 DOI: 10.1097/iae.0000000000003937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
PURPOSE To investigate eyes with polypoidal lesions associated with choroidal nevi, their multimodal imaging characteristics, and long clinical follow-up. METHODS Multicenter, retrospective case series study of patients with polypoidal lesions overlying choroidal nevi. Demographic and clinical information were recorded. Multimodal imaging including color fundus photography, optical coherence tomography, optical coherence tomography angiography, fundus fluorescein angiography, indocyanine angiography, and A- and B-scan ultrasonography were analyzed for nevus and polypoidal lesion characteristics. RESULTS Fourteen eyes (14 patients; mean age: 70.3 ± 6.7 years) with polypoidal lesions overlying choroidal nevi were included. The mean follow-up duration was 50.0 ± 27.9 months (range 12-108). All nevi were pigmented on color fundus photography, flat on ultrasonography with a mean basal diameter of 3.8 ± 0.4 mm. In all but one eye, optical coherence tomography showed a shallow irregular pigment epithelium detachment overlying the nevus. A total of 11/14 eyes (78.6%) had exudative activity, 9 eyes received intravitreal anti-vascular endothelial growth factor injections, and one eye required intravitreal anti-vascular endothelial growth factor combined with photodynamic therapy. Mean visual acuity was 20/32 at baseline and 20/50 at final visit. CONCLUSION We present the largest known cohort of eyes with polypoidal lesions associated with choroidal nevi with up to 9 years follow-up. The exudative degree of the polypoidal lesion in this condition is variable and treatment decisions should be taken on an individual basis. We hypothesize that choroidal ischemia because of altered choroidal vasculature rather than Haller layer hyperpermeability plays a role in the formation of polypoidal lesions overlying nevi.
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Affiliation(s)
- Nir Gomel
- Ophthalmology Division, Tel Aviv Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michaella Goldstein
- Ophthalmology Division, Tel Aviv Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adrian T Fung
- Westmead and Central Clinical Schools, Specialty of Ophthalmology and Eye Health, The University of Sydney, Sydney, Australia
- Department of Ophthalmology, Faculty of Medicine, Health and Human Sciences, Macquarie University Hospital, Sydney, Australia
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Filippo Tatti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy; and
| | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy; and
| | - Zohar Habot-Wilner
- Ophthalmology Division, Tel Aviv Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Loewenstein
- Ophthalmology Division, Tel Aviv Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Matias Iglicki
- Private Retina Practice, University of Buenos Aires, Buenos Aires, Argentina
| | - Dinah Zur
- Ophthalmology Division, Tel Aviv Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Nissen AHK, Kiilgaard HC, van Dijk EHC, Hajari JN, Huemer J, Iovino C, Schneider M, Sørensen TL, Grauslund J, Subhi Y. Exudative Progression of Treatment-Naïve Nonexudative Macular Neovascularization in Age-Related Macular Degeneration: A Systematic Review With Meta-Analyses. Am J Ophthalmol 2024; 257:46-56. [PMID: 37659600 DOI: 10.1016/j.ajo.2023.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/21/2023] [Accepted: 08/27/2023] [Indexed: 09/04/2023]
Abstract
PURPOSE To systematically review and report the rate of exudative progression over time in patients with nonexudative macular neovascularization (MNV) in age-related macular degeneration (AMD). DESIGN Systematic review with prevalence meta-analyses and individual participant meta-analysis. METHODS We searched 10 literature databases on March 26, 2023, for studies of consecutive patients with treatment-naïve nonexudative MNV in AMD. The primary outcome of interest was time from diagnosis to exudative progression. We conducted meta-analyses on the prevalence of exudative progression at 1 and 2 years. Where possible, we extracted individual participant data from studies and conducted an individual participant meta-analysis and explored the exudative progression using a time-to-event curve. RESULTS We identified 16 eligible studies with a total of 384 eyes with nonexudative MNV. Exudative progression had occurred in 20.9% (95% CI 13.1%-29.8%) of eyes at 1 year and in 30.7% (95% CI 21.8%-40.4%) at 2 years. Similar results were observed in the individual participant meta-analysis, showing exudative progression in 18.9% (95% CI 13.5%-26.3%) of eyes at 1 year and 31.3% (95% CI 24.2%-40.0%) at 2 years. Risk factors for a fast exudative progression were the presence of subretinal lipid globules, large MNV areas, rapid MNV growth, growth in pigment epithelium detachment height and width, appearance of a branching pattern, and development of a hyporeflective halo around the MNV. CONCLUSIONS Nonexudative MNVs in AMD are at high risk of exudative progression. Recognition of these lesions may allow for better individualized follow-up regimens in which closer monitoring may facilitate earlier diagnosis of exudative progression.
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Affiliation(s)
- Anne Helene Køllund Nissen
- From the Department of Ophthalmology, Odense University Hospital (A.H.K.N., H.C.K., J.G.), Odense, Denmark
| | - Hans Christian Kiilgaard
- From the Department of Ophthalmology, Odense University Hospital (A.H.K.N., H.C.K., J.G.), Odense, Denmark
| | - Elon H C van Dijk
- Department of Ophthalmology, Leiden University Medical Centre (E.H.C.v.D.), Leiden, the Netherlands; Department of Ophthalmology, Alrijne Hospital (E.H.C.v.D.), Leiderdorp, the Netherlands
| | - Javad Nouri Hajari
- Department of Ophthalmology, Rigshospitalet (J.N.H., M.S., Y.S.), Copenhagen, Denmark
| | - Josef Huemer
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology (J.H.), London, United Kingdom; Department of Ophthalmology and Optometry, Kepler University Hospital (J.H.), Linz, Austria
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli (C.I.), Naples, Italy
| | - Miklos Schneider
- Department of Ophthalmology, Semmelweis University (M.S.), Budapest, Hungary
| | - Torben Lykke Sørensen
- Department of Ophthalmology, Zealand University Hospital (T.L.S.), Roskilde, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen (T.L.S.), Copenhagen, Denmark
| | - Jakob Grauslund
- From the Department of Ophthalmology, Odense University Hospital (A.H.K.N., H.C.K., J.G.), Odense, Denmark; Department of Clinical Research, University of Southern Denmark (J.G., Y.S.), Odense, Denmark; Department of Ophthalmology, Vestfold Hospital Trust (J.G.), Tønsberg, Norway
| | - Yousif Subhi
- Department of Ophthalmology, Rigshospitalet (J.N.H., M.S., Y.S.), Copenhagen, Denmark; Department of Clinical Research, University of Southern Denmark (J.G., Y.S.), Odense, Denmark.
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Peiretti E, Caporossi T, Tatti F, Scampoli A, Mangoni L, Carlà MM, Siotto Pintor E, Carta V, Iovino C, Rizzo S. Two-port dry vitrectomy for rhegmatogenous retinal detachment: a pilot study. Eye (Lond) 2023; 37:3801-3806. [PMID: 37301938 PMCID: PMC10698169 DOI: 10.1038/s41433-023-02617-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/13/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVE To evaluate the safety and efficacy of a new surgical technique for the management of primary rhegmatogenous retinal detachment (RRD), consisting of localized PPV near the retinal break(s), without infusion line, associated with a drainage of subretinal fluid and cryoretinopexy. METHODS Multicentric prospective study conducted at the University Hospital of Cagliari and IRCCS Fondazione Policlinico Universitario A. Gemelli, Roma. Twenty eyes affected by RRD with the causative retinal break(s) in the superior meridians were enrolled between February 2022 and June 2022. Patients with cataract ≥3, aphakia, significant posterior capsule opacification, giant retinal tears, retinal dialysis, history of trauma and PVR ≥C2 were excluded. All eyes underwent a two-port 25-gauge PPV with localized removal of the vitreous surrounding retinal break(s), followed by 20% SF6 injection and cryopexy. The surgical time was recorded for each procedure. Best-corrected visual acuity (BCVA) was measured at baseline and postoperative 6 months. RESULTS Primary anatomic success at 6 months was achieved by 85% of patients. No complications occurred, except for three (15%) retinal re-detachments. The average surgical time was 8.61 ± 2.16 min. Overall, the difference between pre- and last postoperative mean BCVA was statistically significant (p = 0.02). CONCLUSIONS Two-port dry PPV demonstrated safety and efficacy for the treatment of RRD, reaching an 85% of anatomical success rate. Although further studies are necessary to confirm the efficacy and long-term benefit of this treatment, we believe that this surgical technique could be considered a valid and safe alternative for the management of primary RRD.
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Affiliation(s)
- Enrico Peiretti
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.
| | - Tomaso Caporossi
- Vitreoretinal Surgery Unit, Fatebenefratelli Isola Tiberina Gemelli Isola Hospital, Rome, Italy
- Catholic University Sacro Cuore, Rome, Italy
| | - Filippo Tatti
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Alessandra Scampoli
- Vitreoretinal Surgery Unit, Fatebenefratelli Isola Tiberina Gemelli Isola Hospital, Rome, Italy
- Catholic University Sacro Cuore, Rome, Italy
| | - Lorenzo Mangoni
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Matteo Mario Carlà
- Catholic University Sacro Cuore, Rome, Italy
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Valentina Carta
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Claudio Iovino
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Stanislao Rizzo
- Catholic University Sacro Cuore, Rome, Italy
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Di Candia F, Di Iorio V, Tinto N, Bonfanti R, Iovino C, Rosanio FM, Fedi L, Iafusco F, Arrigoni F, Malesci R, Simonelli F, Rigamonti A, Franzese A, Mozzillo E. An Italian case series' description of thiamine responsive megaloblastic anemia syndrome: importance of early diagnosis and treatment. Ital J Pediatr 2023; 49:158. [PMID: 38037112 PMCID: PMC10691017 DOI: 10.1186/s13052-023-01553-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/12/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Individuals with thiamine-responsive megaloblastic anemia (TRMA) mainly manifest macrocytic anemia, sensorineural deafness, ocular complications, and nonautoimmune diabetes. Macrocytic anemia and diabetes may be responsive to high-dosage thiamine treatment, in contrast to sensorineural deafness. Little is known about the efficacy of thiamine treatment on ocular manifestations. CASES PRESENTATION Our objective is to report data from four Italian TRMA patients: in Cases 1, 2 and 3, the diagnosis of TRMA was made at 9, 14 and 27 months. In 3 out of 4 subjects, thiamine therapy allowed both normalization of hyperglycemia, with consequent insulin suspension, and macrocytic anemia. In all Cases, thiamine therapy did not resolve the clinical manifestation of deafness. In Cases 2 and 3, follow-up showed no blindness, unlike Case 4, in which treatment was started for megaloblastic anemia at age 7 but was increased to high doses only at age 25, when the genetic diagnosis of TRMA was performed. CONCLUSIONS Early institution of high-dose thiamine supplementation seems to prevent the development of retinal changes and optic atrophy in TRMA patients. The spectrum of clinical manifestations is broad, and it is important to describe known Cases to gain a better understanding of this rare disease.
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Affiliation(s)
- Francesca Di Candia
- Department of Translational Medical Science, Section of Pediatrics, Regional Centre of Pediatric Diabetes, Federico II University of Naples, Via S. Pansini 5, Naples, 80131, Italy
| | - Valentina Di Iorio
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Nadia Tinto
- Department of Molecular Medicine and Medical Biotechnology, University of Naples "Federico II", Naples, Italy
- CEINGE Advanced Biotechnology, Naples, Italy
| | - Riccardo Bonfanti
- Department of Pediatrics, Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita Salute San Raffaele University, Milan, Italy
| | - Claudio Iovino
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Maria Rosanio
- Department of Translational Medical Science, Section of Pediatrics, Regional Centre of Pediatric Diabetes, Federico II University of Naples, Via S. Pansini 5, Naples, 80131, Italy
| | - Ludovica Fedi
- Department of Translational Medical Science, Section of Pediatrics, Regional Centre of Pediatric Diabetes, Federico II University of Naples, Via S. Pansini 5, Naples, 80131, Italy
| | - Fernanda Iafusco
- Department of Molecular Medicine and Medical Biotechnology, University of Naples "Federico II", Naples, Italy
| | - Francesca Arrigoni
- Department of Pediatrics, Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Rita Malesci
- Unit of Audiology, Department of Neurosciences, Reproductives and Odontostomatologic Sciences, University of Naples ''Federico II'', Naples, Italy
| | - Francesca Simonelli
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Andrea Rigamonti
- Department of Pediatrics, Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Adriana Franzese
- Department of Translational Medical Science, Section of Pediatrics, Regional Centre of Pediatric Diabetes, Federico II University of Naples, Via S. Pansini 5, Naples, 80131, Italy
| | - Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Regional Centre of Pediatric Diabetes, Federico II University of Naples, Via S. Pansini 5, Naples, 80131, Italy.
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Iovino C, Testa F, Cristiano L, De Rosa L, De Rosa G, Simonelli F. Iatrogenic ophthalmic artery occlusion after platelet-rich plasma dermal filler documented with ultra-widefield imaging. Eur J Ophthalmol 2023; 33:NP74-NP78. [PMID: 36803055 DOI: 10.1177/11206721231156635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
PURPOSE To report a case of iatrogenic ophthalmic artery occlusion (OAO) secondary to platelet-rich plasma (PRP) dermal filler injection for facial rejuvenation documented with ultra-widefield imaging. METHODS Case report. RESULTS A 45-year-old woman developed a sudden and painful vision loss in the left eye (LE) after a dermal filler injection of PRP in the left glabellar region. She immediately received intravenous corticosteroids with no improvements. Two weeks later a complete ophthalmological examination including visual acuity (VA), fundus examination, ultra-widefield fundus autofluorescence and fluorescein angiography, and optical coherence tomography was performed. A diagnosis of iatrogenic OAO in the LE with profound ocular ischemia was made and VA remained no light perception. Monthly follow-up visits were scheduled to ascertain the onset of any ocular complication. CONCLUSIONS Dermal filler injections of PRP can lead to rare but devastating side effects with permanent visual loss. Considering that there is currently no validated treatment strategy, prevention could be the real key of iatrogenic OAO management.
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Affiliation(s)
- Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Testa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Luigi Cristiano
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Luigi De Rosa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giuseppe De Rosa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
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11
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Iovino C, Rosolia A, Damiano L, Iodice CM, Di Iorio V, Testa F, Simonelli F. Pars Plana Vitrectomy in Inherited Retinal Diseases: A Comprehensive Review of the Literature. Life (Basel) 2023; 13:1241. [PMID: 37374028 DOI: 10.3390/life13061241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/04/2023] [Accepted: 05/21/2023] [Indexed: 06/29/2023] Open
Abstract
Inherited retinal diseases (IRDs) are a group of clinically and genetically heterogeneous disorders that may be complicated by several vitreoretinal conditions requiring a surgical approach. Pars plana vitrectomy (PPV) stands as a valuable treatment option in these cases, but its application in eyes with such severely impaired chorioretinal architectures remains controversial. Furthermore, the spreading of gene therapy and the increasing use of retinal prostheses will end up in a marked increase in demand for PPV surgery for IRD patients. The retinal degeneration that typically affects patients with hereditary retinal disorders may influence the execution of the surgery and the expected results. Considering the importance of PPV application in IRD-related complications, it is fundamental to try to understand from the literature what is adequate and safe in posterior eye segment surgery. Use of dyes, light toxicity, and risk of wounding scar development have always been themes that discourage the execution of vitreoretinal surgery in already impaired eyes. Therefore, this review aims to comprehensively summarize all PPV applications in different IRDs, highlighting the favorable results as well as the potential precautions to consider when performing vitreoretinal surgery in these eyes.
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Affiliation(s)
- Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Andrea Rosolia
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Luciana Damiano
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Clemente Maria Iodice
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Valentina Di Iorio
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Francesco Testa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
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12
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Iovino C, Iodice CM, Pisani D, Damiano L, Di Iorio V, Testa F, Simonelli F. Clinical Applications of Optical Coherence Tomography Angiography in Inherited Retinal Diseases: An Up-to-Date Review of the Literature. J Clin Med 2023; 12:jcm12093170. [PMID: 37176614 PMCID: PMC10179546 DOI: 10.3390/jcm12093170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/14/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Optical coherence tomography angiography (OCT-A) is a valuable imaging technique, allowing non-invasive, depth-resolved, motion-contrast, high-resolution images of both retinal and choroidal vascular networks. The imaging capabilities of OCT-A have enhanced our understanding of the retinal and choroidal alterations that occur in inherited retinal diseases (IRDs), a group of clinically and genetically heterogeneous disorders that may be complicated by several vascular conditions requiring a prompt diagnosis. In this review, we aimed to comprehensively summarize all clinical applications of OCT-A in the diagnosis and management of IRDs, highlighting significant vascular findings on retinitis pigmentosa, Stargardt disease, choroideremia, Best disease and other less common forms of retinal dystrophies. All advantages and limitations of this novel imaging modality will be also discussed.
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Affiliation(s)
- Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Clemente Maria Iodice
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Danila Pisani
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Luciana Damiano
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Valentina Di Iorio
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Francesco Testa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
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13
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Caporossi T, Scampoli A, Tatti F, Mangoni L, Carlà MM, Pintor ES, Frongia F, Iovino C, Bernardinelli P, Peiretti E. Two-Port “Dry Vitrectomy” as a New Surgical Technique for Rhegmatogenous Retinal Detachment: Focus on Macula-on Results. Diagnostics (Basel) 2023; 13:diagnostics13071301. [PMID: 37046519 PMCID: PMC10093090 DOI: 10.3390/diagnostics13071301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/20/2023] [Accepted: 03/26/2023] [Indexed: 04/03/2023] Open
Abstract
We evaluated a new surgical technique for treating primary rhegmatogenous retinal detachment (RRD), consisting of localized vitrectomy near the retinal break associated with drainage of subretinal fluid without infusion. Twelve eyes of twelve patients with primary RRDs with macula-on superior, temporal, and/or nasal quadrants’ RRD with retinal breaks between 8 and 4 o’clock, pseudophakic or phakic eyes, were enrolled. All eyes underwent a two-port 25-gauge vitrectomy with localized removal of the vitreous surrounding the retinal break(s), followed by a 20% SF6 injection and cryopexy. The difference between pre-operative (T0) and post-operative mean BCVA at 6 months follow-up (T6) was not statistically significant (0.16 logMAR vs. 0.21 logMAR; p = 0.055). Primary anatomic success at 6 months was achieved by 86% of patients. No other complications, except for two retinal re-detachments linked to an incorrect head position of the patients, were recorded. Although further studies are necessary to evaluate the treatment’s efficacy, we believe our technique could be considered a valid alternative for managing primary RRD.
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Affiliation(s)
- Tomaso Caporossi
- Vitreoretinal Surgery Unit, Fatebenefratelli Isola Tiberina-Gemelli Isola Hospital, 00186 Rome, Italy
- Department of Neuroscience, Sensory Organs and Chest, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | - Alessandra Scampoli
- Vitreoretinal Surgery Unit, Fatebenefratelli Isola Tiberina-Gemelli Isola Hospital, 00186 Rome, Italy
- Department of Neuroscience, Sensory Organs and Chest, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | - Filippo Tatti
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
| | - Lorenzo Mangoni
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
| | - Matteo Mario Carlà
- Department of Neuroscience, Sensory Organs and Chest, Catholic University of the Sacred Heart, 00168 Rome, Italy
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Emanuele Siotto Pintor
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
| | - Francesca Frongia
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
| | - Claudio Iovino
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Patrizio Bernardinelli
- Department of Neuroscience, Sensory Organs and Chest, Catholic University of the Sacred Heart, 00168 Rome, Italy
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Enrico Peiretti
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
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14
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Iovino C, Iodice CM, Pisani D, Rosolia A, Testa F, Giannaccare G, Chhablani J, Simonelli F. Yellow Subthreshold Micropulse Laser in Retinal Diseases: An In-Depth Analysis and Review of the Literature. Ophthalmol Ther 2023; 12:1479-1500. [PMID: 36933125 PMCID: PMC10164197 DOI: 10.1007/s40123-023-00698-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/01/2023] [Indexed: 03/19/2023] Open
Abstract
Yellow subthreshold micropulse laser (YSML) is a retinal laser capable of inducing a biologic response without causing thermal damage to the targeted tissue. The 577-nm YSML is delivered to the retina abiding by different protocols in which wavelength, power, duration, spot size and number of spots can be properly set to achieve the most effective and safe treatment response in various chorioretinal disorders. The ultrashort trains of power modulate the activation of the retinal pigment epithelium cells and intraretinal cells, such as Müller cells, causing no visible retinal scars. Subthreshold energy delivered by YSML stimulates the production of the heat-shock proteins, highly conserved molecules that protect cells against any sort of stress by blocking apoptotic and inflammatory pathways that cause cell damage. YSML treatment allows resorption of the subretinal fluid in central serous chorioretinopathy and intraretinal fluid in various conditions including diabetic macular edema, postoperative cystoid macular edema and other miscellaneous conditions. YSML also seems to modulate the development and progression of reticular pseudodrusen in dry age-related macular degeneration. The aim of this review is to discuss and summarize the safety and efficacy of YSML treatment in retinal diseases.
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Affiliation(s)
- Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Clemente Maria Iodice
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Danila Pisani
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Andrea Rosolia
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Testa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Jay Chhablani
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
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15
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Caplash S, Surakiatchanukul T, Arora S, Maltsev DS, Singh SR, Sahoo NK, Parameshwarappa D, Kulikov AN, Iovino C, Tatti F, Gujar R, Venkatesh R, Reddy NG, Snehith R, Peiretti E, Lupidi M, Chhablani J. Multimodal Imaging Based Predictors for the Development of Choroidal Neovascularization in Patients with Central Serous Chorioretinopathy. J Clin Med 2023; 12:jcm12052069. [PMID: 36902857 PMCID: PMC10004102 DOI: 10.3390/jcm12052069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/07/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023] Open
Abstract
This study evaluated predictors for choroidal neovascularization (CNV) associated with central serous chorioretinopathy (CSCR) based on multimodal imaging. A retrospective multicenter chart review was conducted on 134 eyes of 132 consecutive patients with CSCR. Eyes were classified as per the multimodal imaging-based classification of CSCR at baseline into simple/complex CSCR and primary episode/recurrent/resolved CSCR. Baseline characteristics of CNV and predictors were evaluated with ANOVA. In 134 eyes with CSCR, 32.8% had CNV (n = 44) with 72.7% having complex CSCR (n = 32), 22.7% having simple (n = 10) and 4.5% having atypical (n = 2). Primary CSCR with CNV were older (58 vs. 47, p = 0.00003), with worse visual acuity (0.56 vs. 0.75, p = 0.01) and of longer duration (median 7 vs. 1, p = 0.0002) than those without CNV. Similarly, recurrent CSCR with CNV were older (61 vs. 52, p = 0.004) than those without CNV. Patients with complex CSCR were 2.72 times more likely to have CNV than patients with simple CSCR. In conclusion, CNV associated with CSCR was more likely in complex CSCR and older age of presentation. Both primary and recurrent CSCR are implicated in CNV development. Patients with complex CSCR were 2.72 times more likely to have CNV than patients with simple CSCR. Multimodal imaging-based classification of CSCR supports detailed analysis of associated CNV.
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Affiliation(s)
- Sonny Caplash
- Department of Ophthalmology, University of Pittsburgh Medical Center, 203 Lothrop Street, Pittsburgh, PA 15213, USA
- Correspondence:
| | - Thamolwan Surakiatchanukul
- Department of Ophthalmology, Jamaica Hospital Medical Center, 8900 Van Wyck Expy, New York Medical College, New York, NY 11418, USA
| | - Supriya Arora
- Princess Margaret Hospital, 3MF7+P9G, Shirley St, Nassau P.O. Box N-3730, Bahamas
| | - Dmitrii S. Maltsev
- Department of Ophthalmology, Military Medical Academy, 194044 St. Petersburg, Russia
| | | | - Niroj Kumar Sahoo
- LV Prasad Eye Institute, Kode Venkatadri Chowdary Campus, Penamaluru Rd, Tadigadapa, Vijayawada 521134, India
| | - Deepika Parameshwarappa
- LV Prasad Eye Institute, Kode Venkatadri Chowdary Campus, Penamaluru Rd, Tadigadapa, Vijayawada 521134, India
| | - Alexei N. Kulikov
- Department of Ophthalmology, Military Medical Academy, 194044 St. Petersburg, Russia
| | - Claudio Iovino
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Via Università, 40, 09124 Cagliari, Italy
| | - Filippo Tatti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Via Università, 40, 09124 Cagliari, Italy
| | - Ramkailash Gujar
- Department of Ophthalmology, University of Perugia, S. Maria della Misericordia Hospital, Piazza Università, 1, 06156 Perugia, Italy
| | - Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya Foundation, 1st Main, Binnamangala, Defence Colony, 100 Feet Road, Bengaluru 560099, India
| | - Nikitha Gurram Reddy
- Department of Retina and Vitreous, Narayana Nethralaya Foundation, 1st Main, Binnamangala, Defence Colony, 100 Feet Road, Bengaluru 560099, India
| | - Ram Snehith
- Department of Retina and Vitreous, Narayana Nethralaya Foundation, 1st Main, Binnamangala, Defence Colony, 100 Feet Road, Bengaluru 560099, India
| | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Via Università, 40, 09124 Cagliari, Italy
| | - Marco Lupidi
- Department of Ophthalmology, University of Perugia, S. Maria della Misericordia Hospital, Piazza Università, 1, 06156 Perugia, Italy
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh Medical Center, 203 Lothrop Street, Pittsburgh, PA 15213, USA
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Santoro C, Boccia R, Iovino C, Piluso G, Perrotta S, Simonelli F. Patients carrying Arg1809 substitution with no choroidal abnormalities: a further proof of a "Quasi-Incomplete" NF1 phenotype. Eur J Hum Genet 2023; 31:136-137. [PMID: 36404348 PMCID: PMC9905567 DOI: 10.1038/s41431-022-01236-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
- Claudia Santoro
- Child and Adolescent Neuropsychiatry Clinic, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Via Pansini 5, 80131, Naples, Italy.
- Department of Women's and Children's Health, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy.
| | - Rosa Boccia
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80132, Napoli, Italy.
| | - Claudio Iovino
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80132, Napoli, Italy
| | - Giulio Piluso
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via Luigi De Crecchio 7, 80138, Naples, Italy
| | - Silverio Perrotta
- Department of Women's and Children's Health, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy
| | - Francesca Simonelli
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80132, Napoli, Italy
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17
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Iovino C, Ramtohul P, Au A, Romero-Morales V, Sadda S, Freund KB, Sarraf D. Vitelliform maculopathy: Diverse etiologies originating from one common pathway. Surv Ophthalmol 2023; 68:361-379. [PMID: 36720370 DOI: 10.1016/j.survophthal.2023.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/18/2023] [Accepted: 01/22/2023] [Indexed: 01/31/2023]
Abstract
Vitelliform lesions (VLs) are associated with a wide array of macular disorders but are the result of one common pathway: retinal pigment epithelium (RPE) impairment and phagocytic dysfunction. VLs are defined by the accumulation of yellowish subretinal material. In the era of multimodal advanced retinal imaging, VLs can be further characterized by subretinal hyperreflectivity with optical coherence tomography and hyperautofluorescence with fundus autofluorescence. VLs can be the result of genetic or acquired retinal diseases. In younger patients, VLs usually occur in the setting of Best disease. Additional genetic causes of VL include pattern dystrophy or adult-onset vitelliform macular dystrophy. In older patients, acquired VLs can be associated with a broad spectrum of etiologies, including tractional, paraneoplastic, toxic, and degenerative disorders. The main cause of visual morbidity in eyes with VLs is the onset of macular atrophy and macular neovascularization. Histopathological studies have provided new insights into the location, nature, and lifecycle of the vitelliform material comprised of melanosomes, lipofuscin, melanolipofuscin, and outer segment debris located between the RPE and photoreceptor layer. Impaired phagocytosis by the RPE cells is the unifying pathway leading to VL development. We discuss and summarize the nature, pathogenesis, multimodal imaging characteristics, etiologies, and natural course of vitelliform maculopathies.
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Affiliation(s)
- Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Prithvi Ramtohul
- Vitreous Retina Macula Consultants of New York, New York, NY, USA
| | - Adrian Au
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Veronica Romero-Morales
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - SriniVas Sadda
- Doheny Image Reading Center, Doheny Eye Institute, University of California Los Angeles (UCLA) Affiliated, Los Angeles, CA, USA; Department of Ophthalmology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, NY, USA; Department of Ophthalmology, NYU Grossman School of New York, New York, NY, USA
| | - David Sarraf
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA; Greater Los Angeles Veterans Affairs Healthcare Center, Los Angeles, CA, USA.
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18
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Singh SR, Parameswarappa DC, Arora S, Maltsev DS, Sahoo NK, Kulikov AN, Iovino C, Tatti F, Venkatesh R, Reddy NG, Pulipaka RS, Peiretti E, Chhablani J. Imaging characteristics of bilateral CSCR cases:12 months follow up. Eye (Lond) 2023; 37:97-102. [PMID: 35022564 PMCID: PMC9829729 DOI: 10.1038/s41433-021-01885-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/15/2021] [Accepted: 11/29/2021] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To report the disease pattern, progression and imaging characteristics in eyes with bilateral central serous chorioretinopathy (CSCR). METHODS This was a retrospective case review of bilateral CSCR patients with active disease in at least one eye. Multimodal imaging including fundus photography, fundus autofluorescence, optical coherence tomography (OCT), fluorescein and indocyanine angiography (FA/ICGA) was done at baseline and follow-up visits. Disease classification was done using recently described classification criteria. The degree of asymmetry in the disease distribution pattern at baseline and disease progression during follow-up visit with a minimum duration of 12 months was studied. RESULTS Among 103 CSCR patients, 36 patients (34.95%) with mean age of 53.6 ± 10.5 years had bilateral CSCR at baseline. Five patients (13.9%) had asymmetrical disease i.e. simple in one eye and complex in fellow eye. The remaining 31 patients had symmetric disease (simple, 2; complex 29). Mean duration of follow up was 17.58 ± 13.84 months. There was no significant difference between both eye parameters at last follow up (best corrected visual acuity, BCVA; central macular thickness, CMT; and subfoveal choroidal thickness, SFCT) (all p > 0.05). At last follow up, 22 eyes (2 simple and 20 complex) remained active whereas none of the eyes converted from simple to complex CSCR. CONCLUSION Bilateral disease was more commonly seen with complex CSCR in contrast to simple CSCR. Moreover, disease distribution in complex CSCR had symmetric pattern if bilateral disease was present. None of the simple CSCR eyes converted to complex type.
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Affiliation(s)
- Sumit Randhir Singh
- Jacobs Retina Center at Shiley Eye Center, University of California, San Diego, La Jolla, CA, USA
| | - Deepika C Parameswarappa
- Smt Kanuri Santhamma Center for Vitreo-Retina Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Supriya Arora
- Division of Ophthalmology, Department of Surgery, Princess Margaret Hospital, Nassau, Bahamas
| | - Dmitrii S Maltsev
- Department of Ophthalmology, Military Medical Academy, St Petersburg, Russian Federation
| | - Niroj Kumar Sahoo
- Department of Retina and Vitreous, L V Prasad Eye Institute, Vijayawada, India
| | - Alexei N Kulikov
- Department of Ophthalmology, Military Medical Academy, St Petersburg, Russian Federation
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Filippo Tatti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, India
| | | | | | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh Eye and Ear Institute, Pittsburgh, PA, USA.
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19
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Iovino C, Di Iorio V, Paolercio L, Giordano C, Testa F, Simonelli F. Navigated 577-nm subthreshold micropulse retinal laser treatment for peripapillary pachychoroid syndrome. Am J Ophthalmol Case Rep 2022; 28:101757. [DOI: 10.1016/j.ajoc.2022.101757] [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] [Received: 05/30/2022] [Revised: 10/20/2022] [Accepted: 11/11/2022] [Indexed: 11/23/2022] Open
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20
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Ramtohul P, Iovino C, Au A, Bacci T, Pichi F, Corradetti G, Corvi F, Manoharan N, Marin AI, Tadayoni R, Sadda S, Freund KB, Sarraf D. Clinical and Morphologic Characteristics of Perivenular Fernlike Leakage on Ultrawide-field Fluorescein Angiography. Ophthalmol Retina 2022; 6:1070-1079. [PMID: 35545196 DOI: 10.1016/j.oret.2022.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To analyze the spectrum of the perivenular fernlike leakage on ultrawide-field fluorescein angiography (UWFA) and discuss its potential implications in the current understanding of the retinal venous outflow. DESIGN Retrospective, observational case series. PARTICIPANTS Eyes presenting with fernlike patterns of dye leakage on UWFA were included in this study. METHODS Analysis of the clinical characteristics and multimodal imaging findings using UWFA and wide-angle swept-source OCT-angiography (SS-OCTA). MAIN OUTCOME MEASURES The disease spectrum, anatomic origin, and clinical implications of this fernlike leakage. RESULTS Multimodal retinal images from 40 eyes of 29 patients with fernlike leakage on UWFA were studied. The underlying etiologies included a wide range of inflammatory disorders, including pars planitis (18 eyes) and central retinal vein occlusion (2 eyes). On UWFA, the fernlike leakage originated from the retinal capillaries and venules directly adjacent to the veins and spared the periarterial zone. This perivenular fernlike leakage involved the far periphery in all cases and progressed more diffusely and centripetally in cases with more severe intraocular inflammation. On wide-angle SS-OCTA, the impairment of deep capillary plexus (DCP) flow signals precisely colocalized with the perivenular fernlike leakages identified on UWFA. CONCLUSIONS The fernlike leakage on UWFA refers to the distinctive perivenular dye leakage that originates from the retinal capillaries and venules. Multimodal imaging correlation suggests that the predominant impairment is at the level of the DCP. The axial symmetry of the fernlike leakage with the veins and sparing of the periarterial zone may support the dominant venous role of the DCP.
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Affiliation(s)
- Prithvi Ramtohul
- Centre Hospitalier Universitaire de l'Hôpital Nord, chemin des Bourrely, Marseille, France; Vitreous Retina Macula Consultants of New York, New York, New York
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Adrian Au
- Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Tommaso Bacci
- Vitreous Retina Macula Consultants of New York, New York, New York; Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena University Hospital, Siena, Italy
| | - Francesco Pichi
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Giulia Corradetti
- Department of Ophthalmology, Doheny Image Reading Center, Doheny Eye Institute, University of California Los Angeles (UCLA) Affiliated, Los Angeles, California
| | - Federico Corvi
- Department of Ophthalmology, Doheny Image Reading Center, Doheny Eye Institute, University of California Los Angeles (UCLA) Affiliated, Los Angeles, California
| | - Niranjan Manoharan
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado
| | - Alejandro Itzam Marin
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado
| | - Ramin Tadayoni
- Université de Paris, Ophthalmology Department, AP-HP, Hôpital Lariboisière, Paris, France; Hôpital Fondation Adolphe de Rothschild, 75019, Paris, France
| | - SriniVas Sadda
- Department of Ophthalmology, Doheny Image Reading Center, Doheny Eye Institute, University of California Los Angeles (UCLA) Affiliated, Los Angeles, California
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, New York; Department of Ophthalmology, NYU Grossman School of New York, New York, New York
| | - David Sarraf
- Stein Eye Institute, University of California Los Angeles, Los Angeles, California.
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21
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Newman H, Perlman I, Pras E, Rozenberg A, Ben-Yosef T, Iovino C, Simonelli F, Di Iorio V, Rotenstreich Y, Katzburg E, Ehrenberg M, Iglicki M, Zur D. Reply. Retina 2022; 42:e49. [PMID: 36129272 DOI: 10.1097/iae.0000000000003564] [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] [Received: 05/21/2022] [Accepted: 06/26/2022] [Indexed: 02/04/2023]
Affiliation(s)
- Hadas Newman
- Ophthalmology Division, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ido Perlman
- Ophthalmology Division, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Eran Pras
- Ophthalmology Department, Shamir Hospital, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Assaf Rozenberg
- Ophthalmology Department, Shamir Hospital, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamar Ben-Yosef
- Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical & Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical & Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Valentina Di Iorio
- Eye Clinic, Multidisciplinary Department of Medical, Surgical & Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ygal Rotenstreich
- Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Etti Katzburg
- Ophthalmology Division, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Miriam Ehrenberg
- Ophthalmology Unit, Schneider Children's Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Matias Iglicki
- Private Retina Practice, University of Buenos Aires, Buenos Aires, Argentina
| | - Dinah Zur
- Ophthalmology Division, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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22
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Tatti F, Mangoni L, Pirodda S, Demarinis G, Iovino C, Siotto Pintor E, Orrù G, Lecca LI, Campagna M, Denotti G, Peiretti E. Ocular Surface Changes Associated with Face Masks in Healthcare Personnel during COVID-19 Pandemic. Life (Basel) 2022; 12:1491. [PMID: 36294925 PMCID: PMC9604707 DOI: 10.3390/life12101491] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 02/23/2024] Open
Abstract
The aim of this study was to investigate ocular surface changes associated with face mask (FMs) use of healthcare personnel during the COVID-19 pandemic. We prospectively evaluated 200 eyes of 100 individuals during working hours and 40 eyes of 20 individuals during their rest days as a control group. Dry eye symptoms were assessed with the Ocular Surface Disease Index (OSDI) and McMonnies questionnaire. The clinical investigation included the best corrected visual acuity (BCVA), corneal fluorescein staining (FS), break-up time (BUT), and Schirmer test I before and after a 7-h work shift with a continuative use of surgical or N95 masks. The control group was evaluated similarly twice a day, at 8:00 a.m. and at 3:00 p.m.. In the study group, BCVA, FS, BUT, and Schirmer test were investigated and there was a significant negative variation at the end of the shift. On the contrary, the control group did not show significant variations of any clinical feature. Furthermore, no significant changes in clinical parameters were observed during the use of surgical or N95 masks. In conclusion, FMs continuative use resulted in daily ocular surface modifications specifically in healthcare personnel.
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Affiliation(s)
- Filippo Tatti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
| | - Lorenzo Mangoni
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
| | - Simone Pirodda
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
| | - Giuseppe Demarinis
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
| | - Claudio Iovino
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Emanuele Siotto Pintor
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
| | - Germano Orrù
- Molecular Biology Service Lab, Department of Surgical Science, University of Cagliari, 09124 Cagliari, Italy
| | - Luigi Isaia Lecca
- Division of Occupational Medicine, Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy
| | - Marcello Campagna
- Division of Occupational Medicine, Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy
| | - Gloria Denotti
- Department of Surgical Science, Institute of Dentistry, University of Cagliari, 09124 Cagliari, Italy
| | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
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Guarino O, Iovino C, Di Iorio V, Rosolia A, Schiavetti I, Lanza M, Simonelli F. Anatomical and Functional Effects of Oral Administration of Curcuma Longa and Boswellia Serrata Combination in Patients with Treatment-Naïve Diabetic Macular Edema. J Clin Med 2022; 11:jcm11154451. [PMID: 35956066 PMCID: PMC9369822 DOI: 10.3390/jcm11154451] [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: 06/18/2022] [Revised: 07/23/2022] [Accepted: 07/28/2022] [Indexed: 12/07/2022] Open
Abstract
Anti-vascular endothelial growth factor nowdays represents the standard of care for diabetic macular edema (DME). Nevertheless, the burden of injections worldwide has created tremendous stress on the healthcare system during the COVID-19 pandemic. The aim of this study was to investigate the effects of the oral administration of Curcuma longa and Boswellia serrata (Retimix®) in patients with non-proliferative diabetic retinopathy (DR) and treatment-naïve DME < 400 μm, managed during the COVID-19 pandemic. In this retrospective study, patients were enrolled and divided into two groups, one undergoing observation (Group A, n 12) and one receiving one sachet a day of Retimix® (Group B, n 49). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) measured by spectral-domain optical coherence tomography were performed at baseline, then at one and six months. A mixed-design ANOVA was calculated to determine whether the change in CMT and BCVA over time differed according to the consumption of Retimix®. The interaction between time and treatment was significant, with F (1.032, 102.168) = 14.416; η2 = 0.127; p < 0.001, indicating that the change in terms of CMT and BCVA over time among groups was significantly different. In conclusion, our results show the efficacy of Curcuma longa and Boswellia serrata in patients with non-proliferative DR and treatment-naïve DME in maintaining baseline CMT and BCVA values over time.
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Affiliation(s)
- Olimpia Guarino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (O.G.); (V.D.I.); (A.R.); (M.L.); (F.S.)
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (O.G.); (V.D.I.); (A.R.); (M.L.); (F.S.)
- Correspondence:
| | - Valentina Di Iorio
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (O.G.); (V.D.I.); (A.R.); (M.L.); (F.S.)
| | - Andrea Rosolia
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (O.G.); (V.D.I.); (A.R.); (M.L.); (F.S.)
| | - Irene Schiavetti
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy;
| | - Michele Lanza
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (O.G.); (V.D.I.); (A.R.); (M.L.); (F.S.)
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (O.G.); (V.D.I.); (A.R.); (M.L.); (F.S.)
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Newman H, Perlman I, Pras E, Rozenberg A, Ben-Yosef T, Iovino C, Simonelli F, Di Iorio V, Rotenstreich Y, Katzburg E, Ehrenberg M, Iglicki M, Zur D. THE TARGET SIGN: A Near Infrared Feature and Multimodal Imaging in a Pluri-Ethnic Cohort with RDH5-Related Fundus Albipunctatus. Retina 2022; 42:1364-1369. [PMID: 35250012 DOI: 10.1097/iae.0000000000003466] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE Retinol dehydrogenase 5 (RDH5)-related fundus albipunctatus can present with phenotypic variability. Our purpose was to investigate new clinical characteristics and multimodal imaging findings in patients from different ethnic origins, carrying different mutations. METHODS Multicenter international retrospective case series of 18 patients with genetically confirmed RDH5-related fundus albipunctatus. Patients' files were reviewed for fundus images, visual acuity, macular optical coherence tomography scans, near-infrared images, fundus autofluorescence, electroretinogram, and genetic mutations. Imaging and electroretinogram findings. RESULTS All eyes (n = 36, 100%) showed small circular findings seen on near-infrared images, termed as the "target sign," correlating to the yellowish dots seen clinically and to the distinct hyperreflective linear lesions on optical coherence tomography at the level between external limiting membrane and retinal pigment epithelium. Perifoveal atrophy with foveal sparing was seen in 4 eyes of 2 patients (both RDH5-c.160C>T, p.R54X mutation). Fundus autofluorescence revealed small hyperautofluorescent dots (n = 16, 44.4%). Scotopic electroretinograms were significantly reduced in all cases with an electronegative pattern, 66.7% displayed cone dysfunction. CONCLUSION Our results show distinct imaging findings present in all patients with fundus albipunctatus independent of ethnicity or genetic mutation. Our results can facilitate the current algorithm to diagnose RDH5-related fundus albipunctatus and allow for targeted genetic testing.
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Affiliation(s)
- Hadas Newman
- Ophthalmology Division, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ido Perlman
- Ophthalmology Division, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Eran Pras
- Ophthalmology Department, Shamir Hospital, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Assaf Rozenberg
- Ophthalmology Department, Shamir Hospital, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamar Ben-Yosef
- Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical & Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical & Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Valentina Di Iorio
- Eye Clinic, Multidisciplinary Department of Medical, Surgical & Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ygal Rotenstreich
- Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Etti Katzburg
- Ophthalmology Division, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Miriam Ehrenberg
- Ophthalmology Unit, Schneider Children's Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel ; and
| | - Matias Iglicki
- Private Retina Practice, University of Buenos Aires, Argentina
| | - Dinah Zur
- Ophthalmology Division, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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25
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Sahoo NK, Parameshwarappa DC, Jhingan M, Tatti F, Iovino C, Peiretti E. Interobserver Agreement of Novel Classification of Central Serous Chorioretinopathy. Cureus 2022; 14:e25925. [PMID: 35844339 PMCID: PMC9281466 DOI: 10.7759/cureus.25925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2022] [Indexed: 11/05/2022] Open
Abstract
Objective To validate the newly proposed multimodal-imaging-based classification for central serous chorioretinopathy (CSCR). Methods This was a retrospective study performed in a total of 87 eyes of 44 patients with a diagnosis of CSCR. Multimodal images in the form of auto-fluorescence, fundus fluorescein angiography, indocyanine green angiography, and optical coherence tomography (OCT) images, of all the patients, were presented to two masked retina specialists. The masked observers graded each eye into simple or complex; primary, recurrent, resolved; and specific features such as foveal involvement, outer retinal atrophy, and choroidal neovascularization (CNV). Interobserver agreement was assessed using Cohen's kappa. In areas of non-consensus, a detailed discussion was carried out with a third independent grader. Results The mean age of the 44 patients (32 males and 12 females) was 49.2±9.3 years. We found a moderate-strong agreement between the two observers in all subclassifications, that included “simple or complex” (kappa value=0.91, 95% CI 0.82-0.99, p<0.001); “primary/recurrent/resolved” (kappa value=0.88, 95% CI 0.80-0.96, p<0.001) and “foveal involvement” (kappa value=0.89,95%CI 0.8-0.98, p<0.001). However, there was less agreement between the two graders with respect to classification of “outer retinal atrophy” (kappa value=0.72, 95%CI 0.57-0.87, p<0.001) and “presence/absence of CNV” (kappa value=0.75, 95% CI 0.58-0.92, p<0.001). Non-consensus in categorizing "outer retinal atrophy" was seen in eyes with sub-retinal hyper-reflective material (SHRM) and outer nuclear layer (ONL) thinning overlying subretinal fluid, and non-consensus in categorizing "CNV" was seen in eyes with inner choroidal atrophy. Conclusion Our study reports the validity and strong interobserver agreement in several aspects of the multimodal-imaging-based classification. This could support its implementation in clinical practice and pave way for appropriate treatment guidelines.
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Ferrara M, Romano V, Iovino C, Kadhim MR, van Dijk EHC, Boon CJF, Grassi P, Demirel S, Cartes C, Romano MR. Tips to optimize digital education in ophthalmology: Results from ESASO survey. Eur J Ophthalmol 2022; 33:11206721221093187. [PMID: 35414278 PMCID: PMC9999274 DOI: 10.1177/11206721221093187] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 03/22/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE To identify audience and faculty preferences to optimize digital education sessions in ophthalmology. METHODS We distributed an online survey to ophthalmology trainees and specialists worldwide. The survey investigated respondents' preferences on various findings of hypothetical digital educational sessions. Data were analyzed using descriptive statistics, Fisher's exact probability and ANOVA tests. RESULTS The survey was completed by 655 respondents, from 53 different countries. According to most respondents, the optimal duration and timeframe for a valuable digital education session would be 30-60 min, without a break (52%), in the evening time-slot (6-8 p.m.) (45%) of a weekday (Monday-Thursday) (46%), regardless of age (p-value = 0.84, 0.39, 0.89, respectively) and job position (p-value = 0.31, 0.29, 0.08, respectively). The availability of webinars and recorded surgical videos/clinical cases, associated with live discussion, represented the most important opportunity of digital educational channels for 46% and 42% of respondents, respectively. CONCLUSION Appropriate planning of timing and structure of digital educational ophthalmology sessions may optimize their effectiveness. Using multiple e-learning formats may be helpful to ensure the continuity of learning activities, also in view of a long-term replacement of traditional in-person education.
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Affiliation(s)
| | - Vito Romano
- Department of Corneal and External Eye Diseases, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
- Department of Eye and Vision Science, University of Liverpool, Liverpool, UK
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Mustafa R Kadhim
- Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Elon HC van Dijk
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Camiel JF Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Sibel Demirel
- Department of Ophthalmology, Ankara University School of Medicine, Mamak Street Vehbi Koç Eye Hospital, Dikimevi, Ankara, Turkey
| | - Cristian Cartes
- Unidad oftalmologia, departamento especialidades, Facultad de Medicina, Universidad de la Frontera, Temuco, Chile
| | - Mario R Romano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele - Milano, Italy
- Department of Ophthalmology, Humanitas Gavazzeni-Castelli, Bergamo, Italy
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27
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Iovino C, Peiretti E, Tatti F, Querques G, Borrelli E, Sacconi R, Chhablani J, Agrawal H, Boon CJF, van Dijk EHC, Cennamo G, Lupidi M, Muzi A, Di Iorio V, Iglicki M, Smadar L, Loewenstein A, Zur D. Photodynamic therapy as a treatment option for peripapillary pachychoroid syndrome: a pilot study. Eye (Lond) 2022; 36:716-723. [PMID: 33824506 PMCID: PMC8956648 DOI: 10.1038/s41433-021-01515-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 02/11/2021] [Accepted: 03/15/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To investigate the anatomical and functional results in eyes with peripapillary pachychoroid syndrome (PPS) undergoing photodynamic therapy (PDT). METHODS A total of 25 eyes from 23 patients with PPS treated with PDT were retrospectively evaluated in this multicentric study. Main outcome measure was the proportion of eyes that achieved treatment success, defined as a decrease in both subretinal fluid (SRF) height and central subfield thickness (CST), at 3 months after PDT compared to baseline. Secondary outcomes were the change in CST, SRF, and best-corrected visual acuity (BCVA) 3 months after treatment and predictive factors for treatment success. When available, data between 3 and 12 months were also reviewed. RESULTS Treatment success was achieved in 16 eyes (64%). In the total cohort, CST decreased significantly from 356 ± 118 µm at baseline to 282 ± 90 µm and 270 ± 91 µm at 1 and 3 months, respectively (p < 0.001). Maximal SRF height decreased significantly from 102 ± 83 µm at baseline to 38 ± 46 µm and 32 ± 42 µm at 1 and 3 months, respectively (p < 0.001), and remained stable at month 6 (29 ± 44 µm) and month 12 (23 ± 35 µm). BCVA improved significantly from baseline to month 3 (p = 0.021). CONCLUSIONS PDT can be considered an efficacious treatment option in patients with PPS. Prospective data with longer follow-up in a bigger cohort are needed in order to determine the optimal treatment algorithm in this relatively novel disease.
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Affiliation(s)
- Claudio Iovino
- grid.9841.40000 0001 2200 8888Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Enrico Peiretti
- grid.7763.50000 0004 1755 3242Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Filippo Tatti
- grid.7763.50000 0004 1755 3242Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Giuseppe Querques
- grid.18887.3e0000000417581884Ophthalmology Department, San Raffaele University Hospital, Milan, Italy
| | - Enrico Borrelli
- grid.18887.3e0000000417581884Ophthalmology Department, San Raffaele University Hospital, Milan, Italy
| | - Riccardo Sacconi
- grid.18887.3e0000000417581884Ophthalmology Department, San Raffaele University Hospital, Milan, Italy
| | - Jay Chhablani
- grid.21925.3d0000 0004 1936 9000UPMC Eye Center, University of Pittsburgh, Pittsburgh, PA USA
| | - Hitesh Agrawal
- grid.417748.90000 0004 1767 1636LV Prasad Eye Institute, Hyderabad, India
| | - Camiel J. F. Boon
- grid.10419.3d0000000089452978Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands ,grid.7177.60000000084992262Department of Ophthalmology, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Elon H. C. van Dijk
- grid.10419.3d0000000089452978Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Gilda Cennamo
- grid.4691.a0000 0001 0790 385XEye Clinic, Public Health Department, University of Naples Federico II, Naples, Italy
| | - Marco Lupidi
- grid.9027.c0000 0004 1757 3630Department of Surgical and Biomedical Sciences, Section of Ophthalmology, University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Alessio Muzi
- grid.9027.c0000 0004 1757 3630Department of Surgical and Biomedical Sciences, Section of Ophthalmology, University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Valentina Di Iorio
- grid.9841.40000 0001 2200 8888Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Matias Iglicki
- grid.7345.50000 0001 0056 1981Private Retina Practice, University of Buenos Aires, Buenos Aires, Argentina
| | - Lital Smadar
- grid.12136.370000 0004 1937 0546Division of Ophthalmology, Tel Aviv Sourasky Medical Center affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Loewenstein
- grid.12136.370000 0004 1937 0546Division of Ophthalmology, Tel Aviv Sourasky Medical Center affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dinah Zur
- grid.12136.370000 0004 1937 0546Division of Ophthalmology, Tel Aviv Sourasky Medical Center affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Iovino C, Au A, Ramtohul P, Bacci T, AlBahlal A, Khan AM, Al-Abdullah AA, Wendel R, Chhablani J, Sadda S, Freund KB, Sarraf D. Coincident PAMM and AMN and Insights Into a Common Pathophysiology. Am J Ophthalmol 2022; 236:136-146. [PMID: 34283978 DOI: 10.1016/j.ajo.2021.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/29/2021] [Accepted: 07/06/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE To analyze imaging characteristics and the clinical course of patients demonstrating coincident lesions of paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) in the same eye. DESIGN Retrospective, observational case series. METHODS Lesions from patients presenting with coincident PAMM and AMN in the same eye were evaluated with multimodal imaging including optical coherence tomography (OCT). The association with ocular and systemic findings was also investigated. RESULTS Fifteen subjects (17 eyes) were included in the study. The mean age was 44.4 ± 15.3 years and the follow-up period ranged from 1 to 32 weeks (mean, 11.9 ± 11.4 weeks). The mean visual acuity was 0.8 ± 0.6 logarithm of minimal angle of resolution (Snellen equivalent 20/126) at baseline and 0.3 ± 0.4 logarithm of minimal angle of resolution (Snellen equivalent 20/40) at the last follow-up. PAMM and AMN lesions occurred in the setting of Purtscher's retinopathy (4 eyes, 3 patients), retinal vein occlusion (7 eyes, 7 patients), central retinal artery occlusion (1 eye, 1 patient), and idiopathic retinal vasculitis (1 eye, 1 patient). In 4 eyes (3 patients), an association with other ocular disorders was not identified as evaluated with multimodal imaging. Of the total cohort, 11 eyes (64.7%) showed extension of the AMN hyperreflective bands in Henle's fiber layer with a Z-shaped morphology on OCT B-scan. CONCLUSIONS The presence of coincident PAMM and AMN suggests a common pathophysiologic etiology. This may be the result of retinal vein impairment and hypoperfusion at the level of the deep retinal capillary plexus possibly leading to injury to the Müller glia or photoreceptors in Henle's fiber layer.
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Parameswarappa DC, Arora S, Singh SR, Sahoo NK, Maltsev DS, Kulikov AN, Iovino C, Tatti F, Venkatesh R, Zaheer H, Reddy NG, Pulipaka RS, Peiretti E, Chhablani J. Correction to: Influence of fellow eye on the diagnosis and classification of central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 2021; 260:1427. [PMID: 34762168 DOI: 10.1007/s00417-021-05485-6] [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: 10/19/2022] Open
Affiliation(s)
- Deepika C Parameswarappa
- Smt Kanuri Santhamma Center for Vitreo‑Retina Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Supriya Arora
- Division of Ophthalmology, Department of Surgery, Princess Margaret Hospital, Nassau, Bahamas
| | - Sumit Randhir Singh
- Jacobs Retina Center at Shiley Eye Center, University of California, San Diego, La Jolla, CA, USA
| | - Niroj Kumar Sahoo
- Department of Retina and Vitreous, L V Prasad Eye Institute, Vijayawada, India
| | - Dmitrii S Maltsev
- Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russian Federation
| | - Alexei N Kulikov
- Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russian Federation
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Filippo Tatti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, India
| | - Haniah Zaheer
- Department of Ophthalmology, University of Pittsburgh Eye and Ear Institute, Pittsburgh, PA, USA
| | | | | | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh Eye and Ear Institute, Pittsburgh, PA, USA. .,UPMC Eye Center, University of Pittsburgh, Pittsburgh, PA, USA.
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Arora S, Maltsev DS, Singh Randhir S, Sahoo NK, Jhingan M, Parmeshwarappa D, Arora T, Kulikov A, Iovino C, Zur D, Fainberg G, Ibrahim MN, Tatti F, Gujar R, Venkatesh R, Reddy N, Snehith R, Peiretti E, Lupidi M, Chhablani J. One year outcome and predictors of treatment outcome in central serous chorioretinopathy: Multimodal imaging based analysis. Eur J Ophthalmol 2021; 32:2319-2327. [PMID: 34747194 DOI: 10.1177/11206721211055018] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE To evaluate the follow up and treatment outcome of central serous chorioretinopathy (CSCR) based on the new multimodal imaging-based classification and identify the predictors for anatomic and visual outcome. METHODS Retrospective, multicentric study on 95 eyes diagnosed with CSCR and a follow up of at least 12 months were included. Eyes with macular neovascularization, atypical CSCR or any other disease were excluded. RESULTS At the baseline, observation was advised to 70% eyes with simple CSCR whereas photodynamic therapy (PDT) was performed in 49% eyes with complex CSCR. Over the follow up, decrease in CMT was significantly higher in simple CSCR as compared to complex CSCR (P = 0.008) and the recurrences were significantly more in eyes with lower CMT at baseline (P = 0.0002). Median time of resolution of SRF was 3 months and 6 months in simple and complex CSCR respectively (P = 0.09). For the 12 months follow up, the median fluid free period was greater (P = 0.03) while number of interventions performed was lesser in eyes with simple CSCR as compared to complex CSCR (P = 0.006). Multiple regression analysis showed baseline best corrected visual acuity (BCVA) and baseline persistent SRF to be significantly predictive of BCVA and persistent SRF at 12 months (P < 0.0001, 0.04) respectively. CONCLUSIONS Complex CSCR more often required PDT, was associated with shorter fluid free interval and longer time for SRF resolution. Baseline BCVA and persistent SRF were predictive of final visual and anatomical outcome. The new multimodal imaging based classification is helpful in establishing objective criteria for planning treatment approaches for CSCR.
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Affiliation(s)
- Supriya Arora
- Bahamas Vision Center and Princess Margaret Hospital, Nassau, NP, Bahamas
| | - Dmitrii S Maltsev
- Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russian Federation
| | - Sumit Singh Randhir
- Jacobs Retina Center, Shiley Eye Center, University of California, San Diego, USA
| | - Niroj Kumar Sahoo
- Department of Retina and Vitreous, L V Prasad Eye Institute, Vijayawada, India
| | - Mahima Jhingan
- Jacobs Retina Center, Shiley Eye Center, University of California, San Diego, USA
| | - Deepika Parmeshwarappa
- Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, India
| | - Tarun Arora
- Bahamas Vision Center and Princess Margaret Hospital, Nassau, NP, Bahamas
| | - Alexei Kulikov
- Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russian Federation
| | - Claudio Iovino
- Department of Surgical Sciences, Eye Clinic, 3111University of Cagliari, Cagliari, Italy
| | - Dinah Zur
- Division of Ophthalmology, 26738Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gilad Fainberg
- Division of Ophthalmology, 26738Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Filippo Tatti
- Department of Surgical Sciences, Eye Clinic, 3111University of Cagliari, Cagliari, Italy
| | - Ramkailash Gujar
- Department of Surgical and Biomedical Sciences, Section of Ophthalmology, 60250University of Perugia, Italy
| | - Ramesh Venkatesh
- Department of Retina and Vitreous, 80219Narayana Nethralaya, Bengaluru, India
| | - Nikitha Reddy
- Department of Retina and Vitreous, 80219Narayana Nethralaya, Bengaluru, India
| | - Ram Snehith
- Department of Retina and Vitreous, 80219Narayana Nethralaya, Bengaluru, India
| | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, 3111University of Cagliari, Cagliari, Italy
| | - Marco Lupidi
- Department of Surgical and Biomedical Sciences, Section of Ophthalmology, 60250University of Perugia, Italy
| | - Jay Chhablani
- UPMC Eye Center, 6595University of Pittsburgh, Pittsburgh, USA
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Scorcia V, Giannaccare G, Gatti V, Vaccaro S, Piccoli G, Villì A, Toro MD, Yu AC, Iovino C, Simonelli F, Carnevali A. Intravitreal Dexamethasone Implant in Patients Who Did Not Complete Anti-VEGF Loading Dose During the COVID-19 Pandemic: a Retrospective Observational Study. Ophthalmol Ther 2021; 10:1015-1024. [PMID: 34482532 PMCID: PMC8418689 DOI: 10.1007/s40123-021-00395-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/25/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION To compare the functional and anatomic outcomes between eyes in patients with diabetic macular edema (DME) who underwent a complete anti-vascular endothelial growth factor (VEGF) loading dose with aflibercept and those who were switched to dexamethasone intravitreal (DEX) implant after an incomplete anti-VEGF treatment regimen during the coronavirus disease 2019 (COVID-19) pandemic. METHODS This was a retrospective and comparative study conducted on patients with DME. Main outcome measures were mean change in best corrected visual acuity (BCVA) and central retinal thickness (CRT) from baseline to month 4. RESULTS Forty-three eyes (23 eyes in the anti-VEGF group and 20 eyes in the DEX group) were included. Mean BCVA significantly improved from 37.7 ± 25.3 and 35.7 ± 22.0 letters at baseline to 45.4 (23.9) (mean adjusted BCVA improvement 7.6 ± 20.8 letters, p = 0.033) and 46.1 ± 26.0 (mean adjusted BCVA improvement 10.6 ± 15.9 letters, p = 0.049) at month 4 in the anti-VEGF and DEX groups, respectively, with no significant differences between study groups (mean adjusted BCVA difference 2.8 letters, 95% CI - 9.4 to 14.9 letters, p = 0.648). There were no statistically significant differences in the proportion of eyes that achieved a BCVA improvement of ≥ 5, ≥ 10, and ≥ 15 letters between groups. CRT was significantly reduced from baseline to month 4 in both DEX (mean adjusted CRT reduction 167.3 ± 148.2 µm, p = 0.012) and anti-VEGF groups (mean adjusted CRT reduction 109.9 ± 181.9 µm, p < 0.001), with no differences between them (mean adjusted CRT difference 56.1 µm, 95% CI - 46.0 to 158.2 µm, p = 0.273). Of 20 eyes in the DEX group, 16 (80.0%) and 9 (45.0%) eyes achieved a CRT reduction of ≥ 20% from baseline at 2 months and at 4 months, respectively. CONCLUSIONS Our results seem to suggest that DEX implant can significantly improve both functional and anatomic clinical outcomes in patients who were unable to complete anti-VEGF loading dose during the COVID-19 pandemic.
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Affiliation(s)
- Vincenzo Scorcia
- Department of Ophthalmology, University of Magna Graecia of Cantazaro, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Calabria, Italy
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University of Magna Graecia of Cantazaro, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Calabria, Italy
| | - Valentina Gatti
- Department of Ophthalmology, University of Magna Graecia of Cantazaro, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Calabria, Italy
| | - Sabrina Vaccaro
- Department of Ophthalmology, University of Magna Graecia of Cantazaro, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Calabria, Italy
| | - Gabriele Piccoli
- Department of Ophthalmology, University of Magna Graecia of Cantazaro, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Calabria, Italy
| | - Annarita Villì
- Department of Ophthalmology, University of Magna Graecia of Cantazaro, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Calabria, Italy
| | - Mario Damiano Toro
- Department of Ophthalmology, University Hospital of Zurich, University of Zurich, 9081, Zurich, Switzerland
| | - Angeli Christy Yu
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Claudio Iovino
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, University of Campania Luigi Vanvitelli School of Medicine and Surgery, Naples, Italy
| | - Francesca Simonelli
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, University of Campania Luigi Vanvitelli School of Medicine and Surgery, Naples, Italy
| | - Adriano Carnevali
- Department of Ophthalmology, University of Magna Graecia of Cantazaro, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Calabria, Italy.
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Sahoo NK, Singh SR, Beale O, Nkrumah G, Rasheed MA, Jabeen A, Vupparaboina KK, Ibrahim MN, Tatti F, Chandra K, Lanza M, Iovino C, Peiretti E, Chhablani J. Choroidal Vascularity Map in Unilateral Central Serous Chorioretinopathy: A Comparison with Fellow and Healthy Eyes. Diagnostics (Basel) 2021; 11:diagnostics11050861. [PMID: 34064718 PMCID: PMC8150964 DOI: 10.3390/diagnostics11050861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/07/2021] [Accepted: 05/08/2021] [Indexed: 11/23/2022] Open
Abstract
Background: To map the choroidal vascularity index and compare two eyes in patients with unilateral central serous chorioretinopathy (CSCR). Methods: This was a retrospective, observational study performed in patients with unilateral CSCR. Choroidal thickness (CT) and Choroidal vascularity index (CVI) were measured and mapped in various zones according to the early treatment diabetic retinopathy (ETDRS) grid. Results: A total of 20 CSCR patients (20 study and 20 fellow eyes) were included in the study. Outer nasal region CT was seen to be significantly lower than central CT (p = 0.042) and inner nasal CT (p = 0.007); outer ring CT was significantly less than central (p = 0.04) and inner ring (p = 0.01) CT in CSCR eyes. On potting all the CVI values against the corresponding CT values, a positive correlation was seen in CSCR eyes (r = 0.54, p < 0.01), which was slightly weaker in fellow eyes (r = 0.3, p < 0.01) and a negative correlation was seen in healthy eyes (r = −0.262, p < 0.01). Conclusions: Correlation between CVI and CT was altered in CSCR eyes as compared to fellow and normal eyes with increasing CVI towards the center of the macula and superiorly in CSCR eyes.
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Affiliation(s)
- Niroj Kumar Sahoo
- Department of Retina and Vitreous, L V Prasad Eye Institute, Vijayawada 521134, India;
| | - Sumit Randhir Singh
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, CA 92697, USA;
| | - Oliver Beale
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA 15213, USA; (O.B.); (G.N.); (K.K.V.)
| | - Gideon Nkrumah
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA 15213, USA; (O.B.); (G.N.); (K.K.V.)
| | - Mohammed Abdul Rasheed
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (M.A.R.); (A.J.)
| | - Asiya Jabeen
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (M.A.R.); (A.J.)
| | | | - Mohammed Nasar Ibrahim
- Department of Electrical Engineering, Indian Institute of Technology, Hyderabad 502285, India;
| | - Filippo Tatti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 9121 Cagliari, Italy; (F.T.); (E.P.)
| | - Khushboo Chandra
- Department of Vitreoretina, Disha Eye Hospitals Pvt Ltd., 88(63A) Ghosh Para Road, Barrackpore, Kolkata 700120, India;
| | - Michele Lanza
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.L.); (C.I.)
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.L.); (C.I.)
| | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 9121 Cagliari, Italy; (F.T.); (E.P.)
| | - Jay Chhablani
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA 15213, USA; (O.B.); (G.N.); (K.K.V.)
- Correspondence: ; Tel.: +1-412-377-1943
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Singh SR, Beale O, Nkrumah G, Rasheed MA, Sahoo NK, Vupparaboina KK, Tatti F, Chandra K, Iovino C, Peiretti E, Chhablani J. Correlation of sectoral choroidal vascularity with angiographic leakage in central serous chorioretinopathy. Eur J Ophthalmol 2021; 32:11206721211013653. [PMID: 33947248 DOI: 10.1177/11206721211013653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To correlate sectoral choroidal vascularity with angiographic leakage in eyes with central serous chorioretinopathy (CSCR). METHODS This was a retrospective, cross-sectional study including patients with active CSCR. Multimodal imaging including fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) were performed to identify leakage site and obtain choroidal measurements, respectively. An automated algorithm was used to perform shadow compensation, choroidal boundary localization and binarization, three (3-D) dimensional mapping, and early treatment of diabetic retinopathy study (ETDRS) grid based choroidal quantification that is, choroidal thickness (CT) and choroidal vascularity index (CVI). Nested analysis of variance (ANOVA) was performed to compare CT and CVI in different sectors. RESULTS Thirty-two eyes with active CSCR were analyzed. CT values varied significantly among the sectors (range, 450.27-482.63 µm; p = 0.005) and rings (range, 459.71-480.45 µm; p < 0.001), however, CVI failed to show significant variation among various segments (sectors, rings, and quadrants; range, 0.53-0.54; all p values > 0.05). Among 25 leaking spots in 25 different sectors, 12 (48%) had an increased CT compared to the overall CT whereas only 24% had increased CVI compared to overall CVI. Mean CT and CVI of the sectors with leakage (427.1 ± 81.1 µm; 0.51 ± 0.05) and remaining sectors without leakage (411.3 ± 73.9 µm; 0.53 ± 0.04) were not statistically different (p = 0.48; p = 0.12, respectively). CONCLUSION Though CT varied in different segments and increased CT corresponded to leakage points on FFA in 48% of eyes, CVI changes were more diffusely spread and local changes in CVI were not predictive of leakage location in eyes with active CSCR.
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Affiliation(s)
- Sumit Randhir Singh
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, USA
| | - Oliver Beale
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA, USA
| | - Gideon Nkrumah
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Niroj Kumar Sahoo
- L. V. Prasad Eye Institute, Tadigadapa, Vijayawada, Andhra Pradesh, India
| | | | - Filippo Tatti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Khushboo Chandra
- Dept. of Vitreoretina, Disha Eye Hospitals Pvt Ltd, Kolkata, India
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Jay Chhablani
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA, USA
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Iovino C, Peiretti E, Giannaccare G, Scorcia V, Carnevali A. Evolving Treatment Paradigm in the Management of Diabetic Macular Edema in the Era of COVID-19. Front Pharmacol 2021; 12:670468. [PMID: 33912065 PMCID: PMC8072466 DOI: 10.3389/fphar.2021.670468] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 03/10/2021] [Indexed: 12/28/2022] Open
Affiliation(s)
- Claudio Iovino
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | | | - Vincenzo Scorcia
- Department of Ophthalmology, University of Magna Graecia, Catanzaro, Italy
| | - Adriano Carnevali
- Department of Ophthalmology, University of Magna Graecia, Catanzaro, Italy
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Iovino C, Demarinis G, Tatti F, Peiretti E. Simultaneous presentation of idiopathic macular and posterior full-thickness retinal holes successfully treated with inverted internal limiting membrane flap technique. Am J Ophthalmol Case Rep 2021; 22:101070. [PMID: 33763622 PMCID: PMC7973865 DOI: 10.1016/j.ajoc.2021.101070] [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: 09/28/2020] [Revised: 01/17/2021] [Accepted: 03/05/2021] [Indexed: 11/05/2022] Open
Abstract
Purpose To report an unusual non-iatrogenic case of central macular and posterior full-thickness retinal holes (FTRHs). Observations A 60-year-old man presented with a progressive visual loss in the right eye. A complete ophthalmological evaluation including best corrected visual acuity (BCVA) measurement, fundus examination and spectral - domain optical coherence tomography (SD–OCT) was performed. Fundus examination and SD-OCT confirmed the presence of simultaneous macular and posterior FTRHs. A 25-gauge vitrectomy was performed and the internal limiting membrane (ILM) was grasped and peeled off around the two holes. A fragment of the peeled-off ILM anchored on the FTRHs edges was left and inserted into the gaps. Closure of both retinal holes was achieved at 1-month, and BCVA improved from 20/630 at baseline to 20/63 at month 3. No intraoperative or postoperative complications were recorded. Conclusions and Importance Inverted ILM flap technique represents a good treatment option in this rare non-iatrogenic condition, allowing a good anatomical and functional recovery.
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Affiliation(s)
- Claudio Iovino
- Eye Clinic, Department of Surgical Science, University of Cagliari, Cagliari, Italy.,Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giuseppe Demarinis
- Eye Clinic, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Filippo Tatti
- Eye Clinic, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Enrico Peiretti
- Eye Clinic, Department of Surgical Science, University of Cagliari, Cagliari, Italy.,Clinica Oculistica, San Giovanni di Dio Hospital, Azienda Ospedaliera Universitaria di Cagliari, Cagliari, Italy
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36
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Iovino C, Di Iorio V, Testa F, Bombace V, Melillo P, Vupparaboina KK, Chhablani J, Simonelli F. Choroidal Vascularity Features in Patients with Choroideremia and Cystoid Spaces. Diagnostics (Basel) 2021; 11:diagnostics11030382. [PMID: 33668232 PMCID: PMC7996232 DOI: 10.3390/diagnostics11030382] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/20/2021] [Accepted: 02/21/2021] [Indexed: 11/16/2022] Open
Abstract
Cystoid spaces (CSs) are a common retinal finding in choroideremia (CHM) patients. The aim of this study was to analyze the vascular features of the choroid associated with the presence of CSs in patients with confirmed genetic diagnosis of CHM. A total of 33 patients (33 eyes) were enrolled in this retrospective cross-sectional study and divided into two groups based on the presence (17 eyes) or absence (16 eyes) of CSs. Choroidal features were evaluated on spectral-domain optical coherence tomography including subfoveal choroidal thickness (CT), total choroidal area (TCA), luminal choroidal area (LCA), and stromal choroidal area (SCA). The choroidal vascularity index (CVI) was then calculated in all study eyes. All structural choroidal parameters were calculated both on the entire length of the B-scan and in the central subfoveal 1500 μm. The average age was 37.3 ± 11.6 and 31.4 ± 16.7 years (p = 0.25) and mean logMAR best-corrected visual acuity was 0.11 ± 0.20 and 0.20 ± 0.57 (p = 0.54) in the CHM groups with and without CSs, respectively. There were no significant differences in subfoveal CT, and TCA, LCA, SCA, and CVI evaluated on either the entire scan or in the central 1500 μm (all p > 0.05). All choroidal vasculature parameters exhibited no significant differences between CHM eyes with and without CSs. Our results suggest that the choroid may not be involved in the development of CSs in patients with CHM.
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Affiliation(s)
- Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania ‘Luigi Vanvitelli’, Via Pansini 5, 80131 Naples, Italy; (C.I.); (V.D.I.); (F.T.); (V.B.); (P.M.)
| | - Valentina Di Iorio
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania ‘Luigi Vanvitelli’, Via Pansini 5, 80131 Naples, Italy; (C.I.); (V.D.I.); (F.T.); (V.B.); (P.M.)
| | - Francesco Testa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania ‘Luigi Vanvitelli’, Via Pansini 5, 80131 Naples, Italy; (C.I.); (V.D.I.); (F.T.); (V.B.); (P.M.)
| | - Viviana Bombace
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania ‘Luigi Vanvitelli’, Via Pansini 5, 80131 Naples, Italy; (C.I.); (V.D.I.); (F.T.); (V.B.); (P.M.)
| | - Paolo Melillo
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania ‘Luigi Vanvitelli’, Via Pansini 5, 80131 Naples, Italy; (C.I.); (V.D.I.); (F.T.); (V.B.); (P.M.)
| | - Kiran Kumar Vupparaboina
- Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad 500034, India;
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA;
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania ‘Luigi Vanvitelli’, Via Pansini 5, 80131 Naples, Italy; (C.I.); (V.D.I.); (F.T.); (V.B.); (P.M.)
- Correspondence: ; Tel.: +39-081-7704501
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Preti RC, Iovino C, Abalem MF, Garcia R, Veloso Dos Santos HN, Sakuno G, Au A, Cunha LP, Zacharias LC, Monteiro MLR, Sadda SR, Sarraf D. Prevalence of Focal Inner, Middle, and Combined Retinal Thinning in Diabetic Patients and Its Relationship With Systemic and Ocular Parameters. Transl Vis Sci Technol 2021; 10:26. [PMID: 34003911 PMCID: PMC7900871 DOI: 10.1167/tvst.10.2.26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Purpose To determine the prevalence of focal inner, middle, and combined inner/middle retinal thinning (FIRT, FMRT, and FCRT, respectively) in different stages of diabetic retinopathy (DR) without diabetic macular edema and to assess the relationship between such findings with ocular and systemic parameters. Methods This was a cross-sectional, comparative study comprising healthy participants and diabetic patients with different stages of DR. Forty-nine horizontal macular B-scans from the selected eye were obtained using spectral-domain optical coherence tomography (SD-OCT) and analyzed for the presence of FIRT, FMRT, or FCRT and any relationship with systemic and ocular parameters. Focal retinal thinning (FRT) was subjectively defined as any evidence of inner and/or middle retinal thinning. Results A total of 190 participants (52 healthy participants and 138 diabetic patients) were included. A higher prevalence of FRT was observed in eyes with advanced DR versus healthy eyes and versus diabetic eyes with no DR or mild DR. FIRT and FCRT were significantly greater in eyes with proliferative DR treated with pan-retinal photocoagulation, and FMRT was significantly more common in eyes with severe nonproliferative DR. FRT was significantly more common in patients with coronary artery disease and was positively correlated with diabetes duration, serum creatinine, and glycosylated hemoglobin and negatively correlated with age, estimated glomerular filtration rate, and visual acuity. Conclusions FRT occurs in all stages of DR and is increasingly prevalent with increasing severity of DR. Translational Relevance OCT identification of FRT may provide a surrogate biomarker of retinal and systemic disease in diabetic patients.
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Affiliation(s)
- Rony Carlos Preti
- Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Maria Fernanda Abalem
- Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil.,Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA
| | - Rafael Garcia
- Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | | | - Gustavo Sakuno
- Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | - Adrian Au
- Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Leonardo Provetti Cunha
- Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil.,Department of Ophthalmology, School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | | | | | - Srinivas Reddy Sadda
- Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA
| | - David Sarraf
- Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,Greater Los Angeles Veterans Affairs Healthcare Center, Los Angeles, CA, USA
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38
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Di Iorio V, Mozzillo E, Rosanio FM, Di Candia F, Genesio R, Testa F, Iovino C, Franzese A, Simonelli F. Case Report: Ophthalmologic Evaluation Over a Long Follow-Up Time in a Patient With Wolfram Syndrome Type 2: Slowly Progressive Optic Neuropathy as a Possible Clinical Finding. Front Pediatr 2021; 9:661434. [PMID: 33996696 PMCID: PMC8116581 DOI: 10.3389/fped.2021.661434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/07/2021] [Indexed: 11/29/2022] Open
Abstract
Wolfram syndrome (WFS) is a rare autosomal recessive neurodegenerative disease whose diagnosis requires diabetes mellitus and optic atrophy (OA). WFS includes a wide spectrum of other possible complications such as diabetes insipidus, sensorineural deafness, urinary tract problems, neurological and psychiatric disorders. Most WFS patients show type 1 syndrome (WFS1) caused by mutations in the WFS1 gene, encoding Wolframin protein, while few patients are affected by WFS type 2 (WFS2) due to a pathogenetic variants in the CISD2 gene encoding an endoplasmic reticulum intermembrane small protein. WFS2 is considered a phenotypic and genotypic variant of WFS, from which differs only for the increased risk of bleeding and presence of peptic ulcers. OA and diabetes are considered cardinal features of WFS. We hereby report the ophthalmologic evaluation in a patient, previously described, with WFS2 after 8 years of follow-up. A 20-year-old white woman was referred to our retinal center for the first time in 2012 following a diagnosis of a novel intragenic exon 2 CISD2 homozygous deletion, for the suspicion of an associated bilateral OA. Fundus examination, spectral-domain optical coherence tomography, visual field, visual evoked potentials were performed and confirmed the presence of an optic neuropathy that remained stable over 8 years follow up. A slowly progressive optic neuropathy, rather than OA can characterize patients with WFS2 and CISD2 intragenic deletion.
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Affiliation(s)
- Valentina Di Iorio
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Enza Mozzillo
- Section of Pediatrics, Department of Translational Medical Science, Regional Center of Pediatric Diabetes, Federico II University of Naples, Naples, Italy
| | - Francesco Maria Rosanio
- Section of Pediatrics, Department of Translational Medical Science, Regional Center of Pediatric Diabetes, Federico II University of Naples, Naples, Italy
| | - Francesca Di Candia
- Section of Pediatrics, Department of Translational Medical Science, Regional Center of Pediatric Diabetes, Federico II University of Naples, Naples, Italy
| | - Rita Genesio
- Department of Molecular Medicine and Medical Biotechnology, University of Naples, Naples, Italy
| | - Francesco Testa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Adriana Franzese
- Section of Pediatrics, Department of Translational Medical Science, Regional Center of Pediatric Diabetes, Federico II University of Naples, Naples, Italy
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
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Bacherini D, Mastropasqua R, Borrelli E, Capuano V, Iovino C, Dragotto F, Caporossi T, Rizzo S, Giansanti F. OCT-A in the Management of Vitreoretinal Diseases and Surgery. Asia Pac J Ophthalmol (Phila) 2021; 10:12-19. [PMID: 33512825 DOI: 10.1097/apo.0000000000000373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Optical coherence tomography angiography is a relatively new noninvasive technique that is changing our approach in the management of several retinal diseases such as neovascular age-related macular degeneration, occlusive retinal diseases, or diabetic retinopathy, but it could also be useful in nonprimary vascular retinal pathologies such as vitreoretinal interface surgical disorders.In idiopathic vitreoretinal interface disorders and surgical retinal diseases, the study of vascular involvement, not commonly assessed by invasive methods, could be useful to reveal specific vascular abnormalities. Such information may be useful for a more detailed phenotyping of each clinical picture before and after surgical treatment, providing potential new prognostic biomarkers.The review discusses the current and potential utility of optical coherence tomography angiography to study vitreoretinal pathologies of surgical interest.
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Affiliation(s)
- Daniela Bacherini
- Department of Neurosciences, Psychology, Drug Research and Child Health Eye Clinic, University of Florence, AOU Careggi, Florence, Italy
- YORIS, Young Ophthalmologists Retinal Imaging Society
| | - Rodolfo Mastropasqua
- YORIS, Young Ophthalmologists Retinal Imaging Society
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Enrico Borrelli
- YORIS, Young Ophthalmologists Retinal Imaging Society
- Division of Head and Neck, Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Vittorio Capuano
- YORIS, Young Ophthalmologists Retinal Imaging Society
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Claudio Iovino
- YORIS, Young Ophthalmologists Retinal Imaging Society
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Dragotto
- Department of Neurosciences, Psychology, Drug Research and Child Health Eye Clinic, University of Florence, AOU Careggi, Florence, Italy
| | - Tomaso Caporossi
- Department of Neurosciences, Psychology, Drug Research and Child Health Eye Clinic, University of Florence, AOU Careggi, Florence, Italy
| | - Stanislao Rizzo
- UOC Oculistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy; Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Pisa, Italy
| | - Fabrizio Giansanti
- Department of Neurosciences, Psychology, Drug Research and Child Health Eye Clinic, University of Florence, AOU Careggi, Florence, Italy
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Singh SR, Iovino C, Zur D, Masarwa D, Iglicki M, Gujar R, Lupidi M, Maltsev DS, Bousquet E, Bencheqroun M, Amoroso F, Lima LH, Padhy SK, Govindahari V, Chandra K, Souied EH, Rodriguez FJ, Daza LA, Rios HA, Cagini C, Peiretti E, Behar-Cohen F, Chhablani J. Central serous chorioretinopathy imaging biomarkers. Br J Ophthalmol 2020; 106:553-558. [PMID: 33288526 DOI: 10.1136/bjophthalmol-2020-317422] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/21/2020] [Accepted: 11/18/2020] [Indexed: 11/04/2022]
Abstract
PURPOSE To identify the factors predicting the visual and anatomical outcomes in eyes with central serous chorioretinopathy (CSCR) through 12 months. METHODS Patients with diagnosis of CSCR, either acute or chronic, were included in this multicentric, retrospective study. Demographic factors; systemic risk factors; central macular thickness (CMT), subfoveal choroidal thickness (SFCT), linear extent of ellipsoid zone (EZ) and interdigitation zone damage on optical coherence tomography; details of leak on fluorescein angiography and indocyanine green angiography were included as predictors of anatomical and visual outcomes. Regression analysis was performed to correlate the changes in best corrected visual acuity (BCVA) and resolution of disease activity. RESULTS A total of 231 eyes of 201 patients with a mean age (49.7±11.8 years) were analysed. A total of 97 and 134 eyes were classified as acute and chronic CSCR. BCVA (0.35±0.31 to 0.24±0.34; p<0.001), baseline optical coherence tomography (OCT) parameters including CMT (p<0.001), subretinal fluid (SRF) height (p<0.001) and SFCT (p=0.05) showed a significant change through 12 months. Multivariate regression analysis showed change in CMT (p≤0.01) and SRF height at baseline (p=0.05) as factors predictive of good visual outcome. Logistic regression analysis revealed changes in both CMT (p=0.009) and SFCT (p=0.01) through 12 months to correlate with the resolution of disease. CONCLUSION OCT parameters such as changes in both CMT and SFCT along with subfoveal EZ damage can be predictive of disease resolution whereas changes in CMT and baseline SRF height correlate well with changes in BCVA through 12 months.
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Affiliation(s)
- Sumit Randhir Singh
- Jacobs Retina Center, University of California San Diego, La Jolla, California, USA
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Università degli studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Dinah Zur
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dua Masarwa
- Department of Ophthalmology, Barzilai University Medical Center, Ashkelon, Israel
| | - Matias Iglicki
- Private Retina Service, University of Buenos Aires, Buenos Aires, Argentina
| | - Ramkailash Gujar
- Department of Surgical and Biomedical Sciences, Section of Ophthalmology, University of Perugia, Perugia, Italy
| | - Marco Lupidi
- Department of Ophthalmology, University of Perugia, Perugia, Italy
| | - Dmitrii S Maltsev
- Ophthalmology, Military Maedical Academy, Saint Petersburg, Russian Federation
| | | | - Mehdi Bencheqroun
- Ophtalmopôle, Cochin Hospital, Paris Descartes University, Paris, France
| | - Francesca Amoroso
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, Creteil, France
| | - Luiz H Lima
- Ophthalmology, Federal University of Sao Paulo, São Paulo, Brazil
| | | | - Vishal Govindahari
- Retina and Uveitis Service, L V Prasad Eye Institute, MTC Campus, Bhubaneswar, India
| | - Khushboo Chandra
- Dept. of Vitreoretina, Disha Eye Hospitals Pvt Ltd, Kolkata, India
| | - Eric H Souied
- Ophthalmology, Centre Hospitalier Intercommunal de Creteil, Creteil, France
| | | | - Laura A Daza
- Fundacion Oftalmologica Nacional, Universidad del Rosario, Bogota, Colombia
| | - Hernan A Rios
- Fundacion Oftalmologica Nacional, Universidad del Rosario, Bogota, Colombia
| | - Carlo Cagini
- Department of Biomedical and Surgical Sciences, University of Perugia School of Medicine and Surgery, Perugia, Italy
| | - Enrico Peiretti
- Eye Clinic, Universita degli Studi di Cagliari, Cagliari, Italy
| | | | - Jay Chhablani
- UPMC Eye Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Giannaccare G, Pellegrini M, Bernabei F, Senni C, Aloi M, Scalzo GC, Ceravolo D, Iovino C, Scorcia V. Comparative analysis of ocular redness score evaluated automatically in glaucoma patients under different topical medications. Eur J Ophthalmol 2020; 31:2405-2411. [PMID: 33148017 DOI: 10.1177/1120672120969612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To compare ocular redness score calculated automatically between glaucoma patients and healthy controls, and to assess the associations between this score and both demographical and clinical characteristics. METHODS Glaucoma patients under different topical medications and matched controls were enrolled in this observational cross-sectional study. The Keratograph 5M (Oculus Optikgeräte GmbH) was used to automatically measure 5 redness scores: global; nasal bulbar; temporal bulbar; nasal limbal; temporal limbal. The Student t and ANOVA tests were used to compare continuous variables between groups. A multiple linear regression analysis was performed to evaluate the associations between redness scores and the use of different active principles. RESULTS One hundred two glaucoma patients and 32 controls were included. Ocular redness scores were significantly higher in glaucoma patients compared to controls (always p < 0.001). The number of active principles was significantly associated with all the redness scores (always p < 0.05). The use of carbonic anhydrase inhibitors (CAIs) was the strongest predictor of overall redness, followed by prostaglandin analogs (PAs) and alpha-adrenergic agonists (AAAs) (respectively, β = 0.400, p = 0.002; β = 0.330, p = 0.013; β = 0.311, p = 0.044). The post hoc analysis measuring the effect of different PAs on redness scores showed that overall redness and bulbar nasal redness scores were significantly lower in patients using tafluprost and latanoprost compared to those using travoprost and bimatoprost 0.01% (respectively, p = 0.025 and p = 0.024). CONCLUSION Ocular redness was significantly higher in patients with glaucoma compared to control subjects. The number of active principles and the use of PAs, CAIs and AAAs were associated with higher redness scores.
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Affiliation(s)
- Giuseppe Giannaccare
- Department of Ophthalmology, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Marco Pellegrini
- Ophthalmology Unit, S.Orsola-Malpighi University Hospital, Bologna, Italy
| | - Federico Bernabei
- Ophthalmology Unit, S.Orsola-Malpighi University Hospital, Bologna, Italy
| | - Carlotta Senni
- Ophthalmology Unit, S.Orsola-Malpighi University Hospital, Bologna, Italy
| | - Maria Aloi
- Department of Ophthalmology, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | | | - Domenico Ceravolo
- Department of Ophthalmology, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Second University of Naples, Naples, Italy
| | - Vincenzo Scorcia
- Department of Ophthalmology, University Magna Græcia of Catanzaro, Catanzaro, Italy
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Pellegrini M, Bernabei F, Mercanti A, Sebastiani S, Peiretti E, Iovino C, Casini G, Loiudice P, Scorcia V, Giannaccare G. Short-term choroidal vascular changes after aflibercept therapy for neovascular age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2020; 259:911-918. [PMID: 33048236 PMCID: PMC8016768 DOI: 10.1007/s00417-020-04957-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/11/2020] [Accepted: 10/01/2020] [Indexed: 01/23/2023] Open
Abstract
Introduction The purpose of this study was to evaluate choroidal vascular changes in patients with neovascular age-related macular degeneration (nAMD) treated with aflibercept injection over a 3-month period. Methods Enhanced depth imaging optical coherence tomography scans of 60 eyes with treatment-naïve nAMD and 60 unaffected fellow eyes were retrospectively analyzed. Data was collected at baseline and after 3 monthly intravitreal injections of aflibercept. The ImageJ software was used to binarize OCT scans and measure total choroid area (TCA), luminal area (LA), and stromal area (SA). Choroidal vascularity index (CVI) was defined as the ratio of LA to TCA. Results After treatment, subfoveal choroidal thickness (CT) in nAMD eyes significantly decreased from 210. 6 ± 61.6 to 194.6 ± 58.7 μm (P < 0.001), TCA from 1.620 ± 0.502 to 1.500 ± 0.451 mm2 (P < 0.001), LA from 1.075 ± 0.335 to 0.985 ± 0.307 mm2 (P < 0.001), SA from 0.545 ± 0.176 to 0.516 ± 0.153 mm2 (P = 0.005), and CVI from 66.36 ± 2.89 to 65.46 ± 2.87% (P = 0.009). The decrease of CVI after treatment was significantly correlated with baseline CVI (Rs = 0.466, P < 0.001), but not with the change in BCVA and presence of dry macula after treatment (always P > 0.05). Conclusion Choroidal thickness and vascularity significantly decreased after treatment with aflibercept in nAMD eyes. Besides the pharmacologic effect on the neovascular lesion, aflibercept may induce vascular changes also on the underlying choroid.
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Affiliation(s)
- Marco Pellegrini
- Ophthalmology Unit, S.Orsola-Malpighi University Hospital, University of Bologna, Via Palagi 9, 40138, Bologna, Italy.
| | - Federico Bernabei
- Ophthalmology Unit, S.Orsola-Malpighi University Hospital, University of Bologna, Via Palagi 9, 40138, Bologna, Italy
| | - Andrea Mercanti
- Ophthalmology Unit, Head and Neck Department of Ophthalmology, Infermi Hospital, Rimini, Italy
| | - Stefano Sebastiani
- Ophthalmology Unit, Head and Neck Department of Ophthalmology, Infermi Hospital, Rimini, Italy
| | - Enrico Peiretti
- Department of Surgical Science, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Giamberto Casini
- Ophthalmology Unit, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Pasquale Loiudice
- Ophthalmology Unit, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Vincenzo Scorcia
- Department of Ophthalmology, University of "Magna Graecia", Catanzaro, Italy
| | - Giuseppe Giannaccare
- Ophthalmology Unit, S.Orsola-Malpighi University Hospital, University of Bologna, Via Palagi 9, 40138, Bologna, Italy.,Department of Ophthalmology, University of "Magna Graecia", Catanzaro, Italy
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Hilely A, Au A, Freund KB, Loewenstein A, Souied EH, Zur D, Sacconi R, Borrelli E, Peiretti E, Iovino C, Sugiura Y, Ellabban AA, Monés J, Waheed NK, Ozdek S, Yalinbas D, Thiele S, de Moura Mendonça LS, Lee MY, Lee WK, Turcotte P, Capuano V, Filali Ansary M, Chakravarthy U, Lommatzsch A, Gunnemann F, Pauleikhoff D, Ip MS, Querques G, Holz FG, Spaide RF, Sadda S, Sarraf D. Non-neovascular age-related macular degeneration with subretinal fluid. Br J Ophthalmol 2020; 105:1415-1420. [PMID: 32920528 DOI: 10.1136/bjophthalmol-2020-317326] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [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: 06/25/2020] [Revised: 08/05/2020] [Accepted: 08/13/2020] [Indexed: 11/03/2022]
Abstract
PURPOSE To evaluate the various patterns of subretinal fluid (SRF) in eyes with age-related macular degeneration (AMD) in the absence of macular neovascularisation (MNV) and to assess the long-term outcomes in these eyes. METHODS This retrospective study included only eyes with non-neovascular AMD and associated SRF. Eyes with evidence of MNV were excluded. Spectral-domain optical coherence tomography (SD-OCT) was obtained at baseline and at follow-up, and qualitative and quantitative SD-OCT analysis of macular drusen including drusenoid pigment epithelial detachment (PED) and associated SRF was performed to determine anatomic outcomes. RESULTS Forty-five eyes (45 patients) were included in this analysis. Mean duration of follow-up was 49.7±36.7 months. SRF exhibited three different morphologies: crest of fluid over the apex of the drusenoid PED, pocket of fluid at the angle of a large druse or in the crypt of confluent drusen or drape of low-lying fluid over confluent drusen. Twenty-seven (60%) of the 45 eyes with fluid displayed collapse of the associated druse or drusenoid PED and 24 (53%) of the 45 eyes developed evidence of complete or incomplete retinal pigment epithelial and outer retinal atrophy. CONCLUSION Non-neovascular AMD with SRF is an important clinical entity to recognise to avoid unnecessary anti-vascular endothelial growth factor therapy. Clinicians should be aware that SRF can be associated with drusen or drusenoid PED in the absence of MNV and may be the result of retinal pigment epithelial (RPE) decompensation and RPE pump failure.
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Affiliation(s)
- Assaf Hilely
- Division of Ophthalmology, Tel Aviv Ichilov-Sourasky Medical Center, Tel Aviv, Israel
| | - Adrian Au
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California, Los Angeles, Los Angeles, California, USA
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, New York, USA
| | - Anat Loewenstein
- Division of Ophthalmology, Tel Aviv Ichilov-Sourasky Medical Center, Tel Aviv, Israel
| | - Eric H Souied
- Ophthalmology, Centre Hospitalier Intercommunal De Creteil, Creteil, France
| | - Dinah Zur
- Division of Ophthalmology, Tel Aviv Ichilov-Sourasky Medical Center, Tel Aviv, Israel
| | | | | | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Claudio Iovino
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Yoshimi Sugiura
- Department of Ophthalmology, University of Tsukuba Faculty of Medicine, Tsukuba, Japan
| | - Abdallah A Ellabban
- Hull University Teaching Hospitals NHS Trust, Hull, UK.,Suez Canal University Faculty of Medicine, Ismailia, Egypt
| | - Jordi Monés
- Barcelona Macula Foundation, Barcelona, Spain
| | - Nadia K Waheed
- New England Eye Center, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Sengul Ozdek
- Department of Ophthalmology, Gazi University, School of Medicine, Ankara, Turkey
| | - Duygu Yalinbas
- Department of Ophthalmology, Gazi University, School of Medicine, Ankara, Turkey
| | - Sarah Thiele
- Ophthalmology, University of Bonn, Bonn, Germany
| | | | - Mee Yon Lee
- Catholic University of Korea College of Medicine, Seoul, South Korea
| | | | | | - Vittorio Capuano
- Ophthalmology, Centre Hospitalier Intercommunal De Creteil, Creteil, France
| | | | - Usha Chakravarthy
- Department of Ophthalmology, Queen's University of Belfast, Belfast, UK
| | - Albrecht Lommatzsch
- Department of Ophthalmology, Sankt Franziskus-Hospital Münster GmbH, Munster, Germany
| | - Frederic Gunnemann
- Department of Ophthalmology, Sankt Franziskus-Hospital Münster GmbH, Munster, Germany
| | - Daniel Pauleikhoff
- Department of Ophthalmology, Sankt Franziskus-Hospital Münster GmbH, Munster, Germany
| | - Michael S Ip
- Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California, USA
| | | | - Frank G Holz
- Ophthalmology, University of Bonn, Bonn, Germany
| | - Richard F Spaide
- Vitreous Retina Macula Consultants of New York, New York, New York, USA
| | - SriniVas Sadda
- Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California, USA
| | - David Sarraf
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California, Los Angeles, Los Angeles, California, USA .,Greater Los Angeles Veterans Affairs Healthcare Center, Los Angeles, California, USA
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Iovino C, Au A, Chhablani J, Parameswarappa DC, Rasheed MA, Cennamo G, Cennamo G, Montorio D, Ho AC, Xu D, Querques G, Borrelli E, Sacconi R, Pichi F, Woodstock E, Sadda SR, Corradetti G, Boon CJF, van Dijk EHC, Loewenstein A, Zur D, Yoshimi S, Freund KB, Peiretti E, Sarraf D. Choroidal Anatomic Alterations After Photodynamic Therapy for Chronic Central Serous Chorioretinopathy: A Multicenter Study. Am J Ophthalmol 2020; 217:104-113. [PMID: 32360342 DOI: 10.1016/j.ajo.2020.04.022] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 04/17/2020] [Accepted: 04/18/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To study the early anatomic choroidal alterations in eyes with chronic central serous chorioretinopathy (CSCR) undergoing photodynamic therapy (PDT). DESIGN Multicenter retrospective cohort study. METHODS A total of 77 patients and 81 eyes with chronic CSCR treated with PDT and 64 untreated fellow eyes were evaluated. Central macular thickness (CMT) and choroidal features including subfoveal choroidal thickness (SFCT), total choroidal area (TCA), luminal choroidal area (LCA), and stromal choroidal area (SCA) were analyzed. Choroidal vascularity index (CVI) was calculated in all study eyes at baseline and at 1- and 3-months post-PDT. RESULTS In eyes receiving PDT, Snellen visual acuity (VA) significantly improved at months 1 and 3 (P < .001). CMT and SFCT showed a significant reduction from baseline at months 1 and 3 (P < .001), whereas TCA and LCA showed a significant decrease only at the 1-month follow-up visit. Baseline mean TCA and LCA were 2.30 ± 1.41 mm2 and 1.23 ± 0.73 mm2, respectively, and decreased to 2.07 ± 1.21 mm2 and 1.08 ± 0.63 mm2 at the 1-month follow-up visit, respectively (P = .01). No significant changes were recorded for SCA and CVI. In the fellow eye group, VA, CMT, and all choroidal parameters showed no differences between baseline and any follow-up visits (all P > .05). CONCLUSIONS After PDT for chronic CSCR we observed sustained reductions in CMT and SFCT, while reductions in TCA and LCA were only noted at the 1-month follow-up interval. These choroidal parameters may provide additional quantitative biomarkers to evaluate the anatomic response to therapy but await further prospective validation.
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Affiliation(s)
- Claudio Iovino
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Adrian Au
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California, Los Angeles, California, USA
| | - Jay Chhablani
- Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Deepika C Parameswarappa
- Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Mohammed Abdul Rasheed
- Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Gilda Cennamo
- Eye Clinic, Public Health Department, University of Naples Federico II, Naples, Italy
| | - Giovanni Cennamo
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Daniela Montorio
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Allen C Ho
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - David Xu
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Giuseppe Querques
- Ophthalmology Department, San Raffaele University Hospital, Milan, Italy
| | - Enrico Borrelli
- Ophthalmology Department, San Raffaele University Hospital, Milan, Italy
| | - Riccardo Sacconi
- Ophthalmology Department, San Raffaele University Hospital, Milan, Italy
| | - Francesco Pichi
- Cleveland Clinic Abu Dhabi, Eye Institute, Abu Dhabi, United Arab Emirates
| | | | - Srinivas R Sadda
- Doheny Eye Institute, University of California, Los Angeles, California, USA
| | - Giulia Corradetti
- Doheny Eye Institute, University of California, Los Angeles, California, USA
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands; Department of Ophthalmology, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Elon H C van Dijk
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Anat Loewenstein
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dinah Zur
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sugiura Yoshimi
- Vitreous Retina Macula Consultants of New York, New York, New York, USA
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, New York, USA
| | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - David Sarraf
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California, Los Angeles, California, USA; Greater Los Angeles VA Healthcare Center, Los Angeles, California, USA.
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Sahoo NK, Mandadi SKR, Singh SR, Sacconi R, Iovino C, Peiretti E, Querques G, Chhablani J. Longitudinal changes in fellow eyes of choroidal neovascularization associated with central serous chorioretinopathy: Optical coherence tomography angiography study. Eur J Ophthalmol 2020; 31:1892-1898. [PMID: 32847399 DOI: 10.1177/1120672120952678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To report longitudinal changes in fellow eyes of chronic central serous chorioretinopathy (CSCR) associated choroidal neovascularization (CNV) using optical coherence tomography angiography (OCTA) and determine factors affecting neovascular conversion. METHODS Medical records of patients with chronic CSCR complicated by CNV and a minimum follow up of 6 months were reviewed. OCT and OCTA features were analyzed at baseline and final follow up. Baseline factors were assessed for predictive value against presence of CNV at follow up and conversion to exudative form. RESULTS Twenty-six subjects (26 CNV and 26 fellow eyes) were included in the study and followed up for a mean period of 26 ± 17 months. Nine eyes had CNV network in fellow eye at baseline, out of which three (33%) had a conversion to exudative CNV. Among the remaining 17 eyes, one eye developed a new network during a period of 44 months. An increase in the size of network was seen from 0.886 ± 0.945 mm2 at baseline to 1.326 ± 1.263 mm2 at follow up. Baseline choroidal thickness at sub-fovea was 345.4 ± 74.9 microns in eyes having network at last visit, compared to 440.1 ± 73.7 microns in eyes having no network.(p < 0.001) None of the baseline variables were found to be significantly associated with conversion to exudative form or presence of CNV on follow up in multivariate analysis. CONCLUSION A conversion rate to exudative form was seen in 33% of fellow eyes with CNV. Relatively thinner choroid at baseline was associated with exudative conversion during follow up.
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Affiliation(s)
- Niroj Kumar Sahoo
- Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, India
| | | | - Sumit Randhir Singh
- Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, India
| | - Riccardo Sacconi
- Ospedale San Raffaele, Ophthalmology, Via Olgettina, Milano, Italy
| | - Claudio Iovino
- Department of Surgical Science, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Enrico Peiretti
- Department of Surgical Science, Eye Clinic, University of Cagliari, Cagliari, Italy
| | | | - Jay Chhablani
- Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, India.,UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA, USA
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Iovino C, Mastropasqua R, Lupidi M, Bacherini D, Pellegrini M, Bernabei F, Borrelli E, Sacconi R, Carnevali A, D’Aloisio R, Cerquaglia A, Finocchio L, Govetto A, Erba S, Triolo G, Di Zazzo A, Forlini M, Vagge A, Giannaccare G. Intravitreal Dexamethasone Implant as a Sustained Release Drug Delivery Device for the Treatment of Ocular Diseases: A Comprehensive Review of the Literature. Pharmaceutics 2020; 12:pharmaceutics12080703. [PMID: 32722556 PMCID: PMC7466091 DOI: 10.3390/pharmaceutics12080703] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 12/13/2022] Open
Abstract
Drug delivery into the vitreous chamber remains a great challenge in the pharmaceutical industry due to the complex anatomy and physiology of the eye. Intravitreal injection is the mainstream route of drug administration to the posterior segment of the eye. The purpose of this review is to assess the current literature about the widening use of the intravitreal 0.7 mg dexamethasone (Dex) implant, and to provide a comprehensive collection of all the ocular disorders that benefit from Dex administration. Although anti-vascular endothelial growth-factors (VEGFs) have been largely indicated as a first-choice level, the Dex implant represents an important treatment option, especially in selected cases, such as vitrectomized eyes or patients in whom anti-VEGF failed or are contraindicated. In this article, the safety profile as well as the list of the possible complications related to intravitreal Dex injection are also discussed.
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Affiliation(s)
- Claudio Iovino
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
- Correspondence: ; Tel.: +39-070-609-2319
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Marco Lupidi
- Department of Surgical and Biomedical Sciences, Section of Ophthalmology, University of Perugia, S. Maria della Misericordia Hospital, 06129 Perugia, Italy; (M.L.); (A.C.)
- Fondazione per la Macula Onlus, DINOMGI., University Eye Clinic, 16132 Genova, Italy
- Centre de l’Odéon, 113 Boulevard St Germain, 75006 Paris, France
| | - Daniela Bacherini
- Department of Neurosciences, Psychology, Drug Research and Child Health, Eye Clinic, University of Florence, AOU Careggi, 50139 Florence, Italy; (D.B.); (L.F.)
| | - Marco Pellegrini
- Ophthalmology Unit, S. Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (M.P.); (F.B.)
| | - Federico Bernabei
- Ophthalmology Unit, S. Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (M.P.); (F.B.)
| | - Enrico Borrelli
- Department of Ophthalmology, Hospital San Raffaele, University Vita Salute San Raffaele, 20132 Milan, Italy; (E.B.); (R.S.)
| | - Riccardo Sacconi
- Department of Ophthalmology, Hospital San Raffaele, University Vita Salute San Raffaele, 20132 Milan, Italy; (E.B.); (R.S.)
| | - Adriano Carnevali
- Department of Ophthalmology, University “Magna Graecia,” 88100 Catanzaro, Italy; (A.C.); (G.G.)
| | - Rossella D’Aloisio
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy;
| | - Alessio Cerquaglia
- Department of Surgical and Biomedical Sciences, Section of Ophthalmology, University of Perugia, S. Maria della Misericordia Hospital, 06129 Perugia, Italy; (M.L.); (A.C.)
| | - Lucia Finocchio
- Department of Neurosciences, Psychology, Drug Research and Child Health, Eye Clinic, University of Florence, AOU Careggi, 50139 Florence, Italy; (D.B.); (L.F.)
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V2PD, UK
| | - Andrea Govetto
- Fatebenefratelli-Oftalmico Hospital, ASST-Fatebenefratelli-Sacco, 63631 Milan, Italy; (A.G.); (S.E.); (G.T.)
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol BS12LX, UK
| | - Stefano Erba
- Fatebenefratelli-Oftalmico Hospital, ASST-Fatebenefratelli-Sacco, 63631 Milan, Italy; (A.G.); (S.E.); (G.T.)
| | - Giacinto Triolo
- Fatebenefratelli-Oftalmico Hospital, ASST-Fatebenefratelli-Sacco, 63631 Milan, Italy; (A.G.); (S.E.); (G.T.)
| | - Antonio Di Zazzo
- Ophthalmology Complex Operative Unit, Campus Bio Medico University Hospital, 00128, Rome, Italy;
| | | | - Aldo Vagge
- University Eye Clinic, DINOGMI, Polyclinic Hospital San Martino IRCCS, 16132 Genoa, Italy;
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University “Magna Graecia,” 88100 Catanzaro, Italy; (A.C.); (G.G.)
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47
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Ferrara M, Romano V, Steel DH, Gupta R, Iovino C, van Dijk EHC, Romano MR. Reshaping ophthalmology training after COVID-19 pandemic. Eye (Lond) 2020; 34:2089-2097. [PMID: 32612174 PMCID: PMC7329193 DOI: 10.1038/s41433-020-1061-3] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/19/2020] [Accepted: 06/19/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on practical activities and didactic teaching of residents and fellows. This survey aimed to propose long-term changes for ophthalmology training based on the changes experienced by trainees and their perception of new training opportunities. METHODS An online survey was distributed to ophthalmology trainees in multiple countries. Descriptive statistics were used to analyse the data. RESULTS A total of 504 analyzable responses were collected from 32 different countries. The current impact of COVID-19 pandemic was described as "severe" by most trainees (55.2%); however, the future perspective was more optimistic as demonstrated by the greater number of responses reporting a presumed "moderate" (37.3%), "mild" (14.1%) or "slight" (4.2%) long-term impact. The vast majority of trainees reported a decrease ≥50% of clinical activity (76.4%) and >75% of surgical activity (74.6%). Although an initial gap in didactic teaching has been experienced by many (55.4%), regular web-based teaching was reportedly attended by 67.7% of the respondents. A strong agreement was found regarding the worthwhile role of web-based case-presentations in clinical training (91.7%), web-based discussion of edited surgical videos (85.7%) and simulation-based practice (86.9%) in surgical training. CONCLUSIONS This survey, focusing on trainees' perspective, strongly reinforces the need to promptly include new technology-based training tools, such as web-based teaching, virtual surgical simulators, and telementoring, in long-term reorganisation of ophthalmology training to ensure its continuity and effectiveness, which would remain available even in the face of another unpredictable crisis within the health system.
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Affiliation(s)
| | - Vito Romano
- Department of Corneal and External Eye Diseases, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.,Department of Eye and Vision Science, University of Liverpool, Liverpool, UK
| | - David H Steel
- Sunderland Eye Infirmary, Sunderland, UK.,Bioscience Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Rajen Gupta
- Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Claudio Iovino
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | | | | | - Mario R Romano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy.,Eye Center, Humanitas Gavazzeni-Castelli, Bergamo, Italy
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48
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Iovino C, Caporossi T, Peiretti E. Vitreoretinal surgery tip and tricks in the era of COVID-19. Graefes Arch Clin Exp Ophthalmol 2020; 258:2869-2870. [PMID: 32548722 PMCID: PMC7296290 DOI: 10.1007/s00417-020-04800-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 05/31/2020] [Accepted: 06/11/2020] [Indexed: 11/17/2022] Open
Affiliation(s)
- Claudio Iovino
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Via Ospedale 48, 09124, Cagliari, Italy
| | - Tomaso Caporossi
- Department of Ophthalmology, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Via Ospedale 48, 09124, Cagliari, Italy.
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49
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Pellegrini M, Vagge A, Ferro Desideri L, Bernabei F, Triolo G, Mastropasqua R, Del Noce C, Borrelli E, Sacconi R, Iovino C, Di Zazzo A, Forlini M, Giannaccare G. Optical Coherence Tomography Angiography in Neurodegenerative Disorders. J Clin Med 2020; 9:E1706. [PMID: 32498362 PMCID: PMC7356677 DOI: 10.3390/jcm9061706] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/29/2020] [Indexed: 12/15/2022] Open
Abstract
Retinal microcirculation shares similar features with cerebral small blood vessels. Thus, the retina may be considered an accessible 'window' to detect the microvascular damage occurring in the setting of neurodegenerative disorders. Optical coherence tomography angiography (OCT-A) is a non-invasive imaging modality providing depth resolved images of blood flow in the retina, choroid, and optic nerve. In this review, we summarize the current literature on the application of OCT-A in glaucoma and central nervous system conditions such as Alzheimer's disease, Parkinson's disease, and multiple sclerosis. Future directions aiming at evaluating whether OCT-A can be an additional biomarker for the early diagnosis and monitoring of neurodegenerative disorders are also discussed.
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Affiliation(s)
- Marco Pellegrini
- Ophthalmology Unit, S. Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (M.P.); (F.B.)
| | - Aldo Vagge
- University Eye Clinic, DINOGMI, Polyclinic Hospital San Martino IRCCS, 16132 Genoa, Italy; (L.F.D.); (C.D.N.)
| | - Lorenzo Ferro Desideri
- University Eye Clinic, DINOGMI, Polyclinic Hospital San Martino IRCCS, 16132 Genoa, Italy; (L.F.D.); (C.D.N.)
| | - Federico Bernabei
- Ophthalmology Unit, S. Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (M.P.); (F.B.)
| | - Giacinto Triolo
- Ophthalmology Department, Fatebenefratelli and Ophthalmic Hospital, ASST-Fatebenefratelli-Sacco, 63631 Milan, Italy;
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Chiara Del Noce
- University Eye Clinic, DINOGMI, Polyclinic Hospital San Martino IRCCS, 16132 Genoa, Italy; (L.F.D.); (C.D.N.)
| | - Enrico Borrelli
- Department of Ophthalmology, Hospital San Raffaele, University Vita Salute San Raffaele, 20132 Milan, Italy; (E.B.); (R.S.)
| | - Riccardo Sacconi
- Department of Ophthalmology, Hospital San Raffaele, University Vita Salute San Raffaele, 20132 Milan, Italy; (E.B.); (R.S.)
| | - Claudio Iovino
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy;
| | - Antonio Di Zazzo
- Department of Ophthalmology, University Campus Bio-Medico of Rome, 00128 Rome, Italy;
| | - Matteo Forlini
- Domus Nova Hospital, 48121 Ravenna, Italy;
- Department of Ophthalmology, Ospedale dello Stato della Repubblica di San Marino, 47893 Città di San Marino, San Marino
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University “Magna Graecia”, 88100 Catanzaro, Italy;
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50
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Au A, Hilely A, Scharf J, Gunnemann F, Wang D, Chehaibou I, Iovino C, Grondin C, Farecki ML, Falavarjani KG, Phasukkijwatana N, Battista M, Borrelli E, Sacconi R, Powell B, Hom G, Greenlee TE, Conti TF, Ledesma-Gil G, Teke MY, Choudhry N, Fung AT, Krivosic V, Baek J, Lee MY, Sugiura Y, Querques G, Peiretti E, Rosen R, Lee WK, Yannuzzi LA, Zur D, Loewenstein A, Pauleikhoff D, Singh R, Modi Y, Hubschman JP, Ip M, Sadda S, Freund KB, Sarraf D. Relationship Between Nerve Fiber Layer Hemorrhages and Outcomes in Central Retinal Vein Occlusion. Invest Ophthalmol Vis Sci 2020; 61:54. [PMID: 32460316 PMCID: PMC7405700 DOI: 10.1167/iovs.61.5.54] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 03/09/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the depth and pattern of retinal hemorrhage in acute central retinal vein occlusion (CRVO) and to correlate these with visual and anatomic outcomes. Methods Retinal hemorrhages were evaluated with color fundus photography and fluorescein angiography at baseline and follow-up. Snellen visual acuity (VA), central foveal thickness (CFT), extent of retinal ischemia, and development of neovascularization were analyzed. Results 108 eyes from 108 patients were evaluated. Mean age was 63.6 ± 16.1 years with a predilection for the right eye (73.1%). Average follow-up was 17.2 ± 19.2 months. Mean VA at baseline was 20/126 and 20/80 at final follow-up. Baseline (P = 0.005) and final VA (P = 0.02) in eyes with perivascular nerve fiber layer (NFL) hemorrhages were significantly worse than in eyes with deep hemorrhages alone. Baseline CFT was greater in the group with perivascular hemorrhages (826 ± 394 µm) compared to the group with deep hemorrhages alone (455 ± 273 µm, P < 0.001). The 10 disc areas of retinal ischemia was more common in patients with perivascular (80.0%) and peripapillary (31.3%) versus deep hemorrhages alone (16.1%, P < 0.001). Neovascularization of the iris was more common, although this differrence was not significant, in the groups with peripapillary (14.3%) and perivascular (2.0%) NFL versus deep hemorrhages alone (0.0%). Conclusions NFL retinal hemorrhages at baseline correlate with more severe forms of CRVO, with greater macular edema, poorer visual outcomes, and greater risk of ischemia and neovascularization. This may be related to the organization of the retinal capillary plexus. The depth and pattern of distribution of retinal hemorrhages in CRVO may provide an easily identifiable early biomarker of CRVO prognosis.
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Affiliation(s)
- Adrian Au
- Stein Eye Institute, University of California, Los Angeles, California, United States
| | - Assaf Hilely
- Stein Eye Institute, University of California, Los Angeles, California, United States
- Ophthalmology Division, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jackson Scharf
- Stein Eye Institute, University of California, Los Angeles, California, United States
| | - Frederic Gunnemann
- Stein Eye Institute, University of California, Los Angeles, California, United States
- Department of Ophthalmology, St. Franziskus-Hospital, Münster, Germany
| | - Derrick Wang
- Stein Eye Institute, University of California, Los Angeles, California, United States
| | - Ismael Chehaibou
- Stein Eye Institute, University of California, Los Angeles, California, United States
| | - Claudio Iovino
- Department of Surgical Science, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Christelle Grondin
- Stein Eye Institute, University of California, Los Angeles, California, United States
| | | | - Khalil Ghasemi Falavarjani
- Eye Research Center and Eye Department, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Nopasak Phasukkijwatana
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Marco Battista
- Department of Ophthalmology, Ospedale San Raffaele Scientific Institute University Vita-Salute San Raffaele, Milan, Italy
| | - Enrico Borrelli
- Department of Ophthalmology, Ospedale San Raffaele Scientific Institute University Vita-Salute San Raffaele, Milan, Italy
| | - Riccardo Sacconi
- Department of Ophthalmology, Ospedale San Raffaele Scientific Institute University Vita-Salute San Raffaele, Milan, Italy
| | - Brittany Powell
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Grant Hom
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Tyler E. Greenlee
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Thais F. Conti
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | | | - Mehmet Yasin Teke
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Netan Choudhry
- Vitreous Retina Macula Specialists of Toronto, Toronto, Ontario, Canada
| | - Adrian T. Fung
- Discipline of Ophthalmology, Westmead and Central Clinical Schools, University of Sydney; Department of Ophthalmology, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Valerie Krivosic
- Hôpital Lariboisière, AP-HP, Université Paris-Diderot, Sorbonne Paris Cité. France
| | - Jiwon Baek
- Department of Ophthalmology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Republic of Korea
| | - Mee Yon Lee
- Department of Ophthalmology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Republic of Korea
| | - Yoshimi Sugiura
- Vitreous Retina Macula Consultants of New York, New York, United States
| | - Giuseppe Querques
- Department of Ophthalmology, Ospedale San Raffaele Scientific Institute University Vita-Salute San Raffaele, Milan, Italy
| | - Enrico Peiretti
- Department of Surgical Science, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Richard Rosen
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Won Ki Lee
- Retina Center, Nune Eye Hospital, Gangnam-gu, Seoul, Republic of Korea
| | | | - Dinah Zur
- Ophthalmology Division, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Loewenstein
- Ophthalmology Division, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Rishi Singh
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Yasha Modi
- Department of Ophthalmology, New York University School of Medicine, New York, New York, United States
| | - Jean Pierre Hubschman
- Stein Eye Institute, University of California, Los Angeles, California, United States
| | - Michael Ip
- Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California, United States
| | - SriniVas Sadda
- Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California, United States
| | - K. Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, United States
| | - David Sarraf
- Stein Eye Institute, University of California, Los Angeles, California, United States
- VA Greater Los Angeles Healthcare System, Los Angeles, California, United States
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