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Viggiano P, Vujosevic S, Palumbo F, Grassi MO, Boscia G, Borrelli E, Reibaldi M, Sborgia L, Molfetta T, Evangelista F, Alessio G, Boscia F. Optical coherence tomography biomarkers indicating visual enhancement in diabetic macular edema resolved through anti-VEGF therapy: OCT biomarkers in resolved DME. Photodiagnosis Photodyn Ther 2024; 46:104042. [PMID: 38460657 DOI: 10.1016/j.pdpdt.2024.104042] [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: 01/19/2024] [Revised: 02/22/2024] [Accepted: 03/06/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE to investigate the structural features and extended visual results in eyes affected by diabetic retinopathy (DR) and diabetic macular edema (DME) that have been successfully treated with anti-vascular endothelial growth factor (VEGF) therapy. METHODS Individuals (39 eyes of 39 patients) who had undergone long-term follow-up and demonstrated evidence of resolved DME after at least 2 years of follow-up following the initiation of anti-VEGF therapy were included. During the ""study visit"", structural OCT scans were examined to assess qualitative features indicative of neuroretina or retinal pigment epithelium distress. Additionally, a quantitative assessment of the inner and outer retinal thicknesses was conducted for topographical analysis. RESULTS The most robust qualitative association observed with BCVA at the "study visit" was linked to the presence of DRIL (p = 0.043) and the appearance of the ELM. (p = 0.045). Regarding quantitative parameters, a strong correlation was noted between the visual acuity during the "study visit" and the foveal and parafoveal thicknesses of both the inner and outer retina (p < 0.001). CONCLUSIONS Changes in the status of ELM, the presence of DRIL, and the thicknesses of the foveal and parafoveal regions can act as OCT biomarkers, signifying prolonged visual improvements in eyes that have experienced resolved DME after undergoing anti-VEGF therapy.
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Affiliation(s)
- Pasquale Viggiano
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Piazza Giulio Cesare,11, Italy.
| | - Stela Vujosevic
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.; Eye Clinic, IRCCS MultiMedica, Milan, Italy
| | - Francesca Palumbo
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Piazza Giulio Cesare,11, Italy
| | - Maria Oliva Grassi
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Piazza Giulio Cesare,11, Italy
| | - Giacomo Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Piazza Giulio Cesare,11, Italy
| | - Enrico Borrelli
- Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy; Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Michele Reibaldi
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Piazza Giulio Cesare,11, Italy; Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy; Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Luigi Sborgia
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Piazza Giulio Cesare,11, Italy
| | - Teresa Molfetta
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Piazza Giulio Cesare,11, Italy
| | - Federica Evangelista
- Department of Ophthalmology, Ente Ecclesiastico Ospedale Generale Regionale "F. Miulli", Acquaviva delle Fonti, Bari, Italy
| | - Giovanni Alessio
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Piazza Giulio Cesare,11, Italy
| | - Francesco Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Piazza Giulio Cesare,11, Italy
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Viggiano P, Boscia G, Borrelli E, Toto L, Grassi MO, Evangelista F, Giancipoli E, Alessio G, Boscia F. Choriocapillaris Reperfusion in Resolved Chronic Central Serous Chorioretinopathy Treated with Eplerenone: Long-Term Effects on the Fellow Eye. Ophthalmol Ther 2023; 12:3199-3210. [PMID: 37747638 PMCID: PMC10640459 DOI: 10.1007/s40123-023-00816-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 09/06/2023] [Indexed: 09/26/2023] Open
Abstract
INTRODUCTION The aim of this work is to utilize swept-source optical coherence tomography angiography (SS-OCTA) to assess the long-term changes in the choroidal and choriocapillaris (CC) layers of the fellow unaffected eye of patients with unilateral resolved chronic central serous chorioretinopathy (cCSC) following treatment with continuous oral eplerenone (EPL). METHODS The study included 35 patients with cCSC and subretinal fluid (SRF) in one eye. SS-OCTA imaging was performed on the fellow cCSC eyes at baseline, 6 months, and 12 months during eplerenone therapy. CC OCT angiography was analyzed to determine the percentage of choriocapillaris flow deficits (FD%), the number of flow deficits (FDn), and the average area of flow deficits (FDa). RESULTS The results demonstrated significant changes in CC flow deficits from baseline to follow-up visits. Specifically, there was a significant decrease in FD% from 28.9 ± 2.2% at baseline to 26.4 ± 1.9% at 6 months (p = 0.023), and further to 24.9 ± 1.7% at 12 months (p = 0.001). Additionally, the FD area gradually contracted over the follow-up period (p < 0.05). Conversely, there was a significant increase in the number of flow deficits compared to baseline (p < 0.05). No statistically significant changes were observed in best-corrected visual acuity (BCVA) at the follow-up visits (p > 0.05). CONCLUSIONS The findings of this study demonstrated long-term reperfusion of the choriocapillaris in unaffected fellow cCSC eyes during continuous oral eplerenone therapy. The beneficial effects of eplerenone therapy were observed after 6 months and maintained at 1 year. These results suggest that specific mineralocorticoid receptor (MR) antagonists may be effective in promoting choriocapillaris recovery in the unaffected eyes of patients with cCSC.
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Affiliation(s)
- Pasquale Viggiano
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, Bari, Italy.
| | - Giacomo Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, Bari, Italy
| | - Enrico Borrelli
- Ophthalmology Department, San Raffaele University Hospital, Milan, Italy
| | - Lisa Toto
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Maria Oliva Grassi
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, Bari, Italy
| | - Federica Evangelista
- Department of Ophthalmology, Ente Ecclesiastico Ospedale Generale Regionale "F. Miulli", Acquaviva Delle Fonti, Bari, Italy
| | | | - Giovanni Alessio
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, Bari, Italy
| | - Francesco Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, Bari, Italy
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Viggiano P, Buonamassa R, Grassi MO, Boscia G, Borrelli E, Landini L, Evangelista F, Malerba MG, Alessio G, Boscia F. Immediate effect of anti-VEGF injections on optic nerve head: Correlation between intraocular pressure and anatomical peripapillary changes. Eur J Ophthalmol 2023:11206721231210749. [PMID: 37899575 DOI: 10.1177/11206721231210749] [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: 10/31/2023]
Abstract
PURPOSE This study was designed to investigate retinal nerve fiber layer (RNFL) and radial peripapillary capillaries (RPC) changes on optical coherence tomography (OCT) angiography and OCT thickness alterations associated with acutely increased intraocular pressure after intravitreal injections. METHODS This observational clinical study was conducted on 35 eyes (35 patients) with treatment-naïve age-related macular degeneration (AMD) and type 1 or type 2 MNV were enrolled. All patients underwent anti-vascular endothelial grow factor (VEGF) intravitreal injections with 0.05-mL aflibercept (2 mg) between January 2022 and October 2022. Peripapillary OCT angiography perfusion density, retinal nerve fiber layer thickness, and intraocular pressure (IOP) were measured before and immediately after intravitreal injections. In particular, the analysis was performed at the following visits: (T0) 5 to 15 min before the injection of aflibercept; (T1) 2 to 5 min after the injection of aflibercept. Paired t-test was used to compare pre-injection and post-injection values. RESULTS The mean baseline IOP (T0) value was 17.26 ± 2.4 mmHg and the immediate post-injection IOP (T1) mean value was 34.7 ± 11.50 mmHg (P < 0.01). The mean global RNFL thickness before and immediately after the injection was 100.9 ± 18.8 m and 98.6 ± 17.4 m (P = 0.001). Furthermore, the topographical RNFL analysis showed significant thickness reduction of the nasal and inferior sectors after the procedure when compared to T0 (P = 0.046 and P = 0.001). On the contrary, the mean RCP density changes at T1 did not reach statistically significant (P = 0.636). Furthermore, we found a significant negative correlation between the retinal nerve fiber layer global thickness and the IOP changes (Pearson's correlation = -0.126; P = 0.031). In particular, the nasal RNFL region showed a significant negative correlations with IOP values (Pearson's correlation = -0.198, P = 0,046). CONCLUSIONS We reported acute IOP changes that are associated with reduced RNFL thickness in a group of patients undergoing intravitreal injections of anti-VEGF drugs for neovascular age-related macular degeneration. Moreover, topographical sub-analysis revealed that the nasal RNFL region is most prone to IOP fluctuations. This finding may explain the sudden visual acuity change in patients immediately after injection and may sustain injuries to optic nerve head structures producing glaucomatous damage.
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Affiliation(s)
- Pasquale Viggiano
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Rosa Buonamassa
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Maria Oliva Grassi
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Giacomo Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Enrico Borrelli
- Ophthalmology Department, San Raffaele University Hospital, Milan, Italy
| | - Luca Landini
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Federica Evangelista
- Ente Ecclesiastico Ospedale Generale Regionale, "F.Miulli", Acquaviva delle Fonti, Italy
| | - Maria Giovanna Malerba
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Giovanni Alessio
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Francesco Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
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Toto L, Ruggeri ML, Evangelista F, Viggiano P, D'Aloisio R, De Nicola C, Falconio G, Di Nicola M, Porreca A, Mastropasqua R. Choroidal modifications assessed by means of choroidal vascularity index after oral eplerenone treatment in chronic central serous chorioretinopathy. Eye (Lond) 2023; 37:1214-1218. [PMID: 35590104 PMCID: PMC10101961 DOI: 10.1038/s41433-022-02091-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 04/07/2022] [Accepted: 05/05/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To investigate choroidal vascularity index (CVI) changes after oral eplerenone treatment in chronic central serous chorioretinopathy (cCSC) using the Spectral-domain (SD)-Optical Coherence Tomography (OCT) with enhanced depth imaging (EDI) mode. METHODS Thirty-six eyes of 18 patients suffering from cCSC with monolateral foveal subretinal fluid (FSRF) successfully treated with oral eplerenone treatment and 18 age-matched healthy subjects were enroled in this retrospective study. EDI-OCT images obtained using Heidelberg Spectralis OCT device in patients with cCSC and FSRF (group 1); fellow eye (group 2) or healthy patients (healthy) were exported and then imported into image analysis ImageJ software for subsequent quantitative analysis. The main outcome measures were luminal area (LA) and CVI. RESULTS A higher value of CVI was detected in group 1 compared to healthy eyes (p = 0.006). LA and CVI significantly reduced during follow up in group 1 and group 2. LA at 120 days was significantly lower compared to all previous time points both in group 1 and group 2 (p < 0.001). Median and [1st -3rd quartile] CVI values were 0.8 [0.7; 1.1] at baseline, 0.8 [0.7; 0.9] at 30 days; 0.7 [0.6; 0.9] at 60 and 90 days and 0.6 [0.5; 0.8] at 120 days in group 1 (p = 0.007) and 0.7 [0.6; 0.9] at baseline, 0.7 [0.7; 0.8] at 30 days; 0.7 [0.6; 0.7] at 60 and 90 days and 0.6 [0.6; 0.7] at 120 days in group 2 (p = 0.018). CONCLUSIONS Choroidal vascularity index reduced in cCSC patients after oral eplerenone treatment during follow up both in eyes with SRF and fellow eyes thus demonstrating the effectiveness of mineral corticoid receptor antagonists in recovering choroidal morphology.
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Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Maria Ludovica Ruggeri
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | | | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
| | - Chiara De Nicola
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Gennaro Falconio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Annamaria Porreca
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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Viggiano P, Grassi MO, Pignataro M, Boscia G, Borrelli E, Molfetta T, Evangelista F, Alessio G, Boscia F. Topographical Analysis of the Choriocapillaris Reperfusion After Loading Anti-VEGF Therapy in Neovascular AMD. Transl Vis Sci Technol 2022; 11:18. [PMID: 36135978 PMCID: PMC9513736 DOI: 10.1167/tvst.11.9.18] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to evaluate choriocapillaris vascular density changes around macular neovascularization (MNV) before and after anti-vascular endothelium growth factor (VEGF) injections by optical coherence tomography angiography (OCTA). Methods Treatment-naïve eyes with a diagnosis of exudative AMD and type 1 MNV were included. En face optical coherence tomography angiograms were analyzed for percentage of choriocapillaris (CC) flow deficit percentage (FD%), the FD average area (FDa), and the FD number (FDn) in 5 progressive 200-µm-wide concentric rings (R1, R2, R3, R4, and R5) surrounding the dark halo around the MNV. The OCTA acquisition was performed at the following visits: (i) before the loading phase of intravitreal injection of aflibercept or ranibizumab (T1), and (ii) 1 month after the last intravitreal injection of loading phase comprising 3 monthly injections (T2). Results A total of 30 eyes of 30 Caucasian patients with treatment naïve neurovascular AMD (nAMD) were included in the study. All rings showed a progressive FD% reduction at T2 in comparison to T1 values indicating gradual CC reperfusion of the peripheral rings. Furthermore, we found a progressive contraction of the FD average area in all the rings considered (P < 0.05). On the other hand, at T2, a significant increase in the FD number of the 5 rings was displayed, as compared to T1 (P < 0.05). Conclusions Our analysis showed topographical CC reperfusion after loading anti-VEGF therapy. CC flow deficits were greater around the associated dark halo before treatment, followed by a progressive recovery of CC flow after intravitreal therapy. Translational Relevance OCTA may be used to assess the development and progression of MNV but also in assessing response to intravitreal injections of anti-VEGF.
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Affiliation(s)
- Pasquale Viggiano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Maria Oliva Grassi
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Mariagrazia Pignataro
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Giacomo Boscia
- Ophthalmology Unit, A.O.U. City of Health and Science of Turin, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Enrico Borrelli
- Ophthalmology Department, San Raffaele University Hospital, Milan, Italy
| | - Teresa Molfetta
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti- Pescara, Chieti, Italy
| | - Giovanni Alessio
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Francesco Boscia
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
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Canosa S, Parmegiani L, Evangelista F, Durando S, Salvagno F, Sestero M, Cimadomo D, Vaiarelli A, Rienzi L, Ubaldi F, Bongioanni F, Revelli A, Gennarelli G. P-442 A new option to thaw slow-frozen human ovarian tissue in cancer patients: efficacy and safety of the combination of different cryopreservation kits. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Is follicular viability of slow-frozen human ovarian tissue preserved if rapid thawing is performed using a solution containing extracellular cryoprotectant only?
Summary answer
Follicular viability is preserved even using thawing solutions containing extracellular cryoprotectant only, combining kits with different composition.
What is known already
Ovarian tissue cryopreservation is an alternative option to oocytes or embryos for fertility preservation in cancer patients facing gonadotoxic treatments. To date, each brand producing kits approved for the slow-freezing of human ovarian tissue recommends the use of its own thawing kit. However, a potential single protocol based on the use of any extracellular cryoprotectant has already been proposed for human oocytes and embryos. The current study aims at finding alternative options to thaw cryopreserved human ovarian tissue when the original kit was withdrawn from the market and only one CE-marked kit was available, even with different composition in cryoprotectants.
Study design, size, duration
Ovarian tissue cryopreservation of ten cancer patients (18.3 ± 7.6 years) undergoing fertility preservation between 2001 and 2012 was performed following a slow-freezing protocol with 1.5M 1,2 PROH and 0.5M Sucrose. Once deceased, for each patient, cortical fragments were prospectively thawed and equally allocated into two groups: i) fragments thawed using 0.5-1M 1,2 PROH and 0.3M Sucrose (PROH+S Group, n = 73); ii) fragments thawed following an adjusted protocol with 0.5M Sucrose only (S Group, n = 73).
Participants/materials, setting, methods
Post thawing follicular density/mm2, integrity (%) and the presence of interstitial oedema were assessed by histological and ultrastructural analysis performed after formalin fixation and haematoxylin/eosin staining. Follicular viability was evaluated by the expression of markers of proliferation (Ki67) and of vascularization (CD31) by immunohistochemistry after a 24h culture in Iscove’s modified Dulbecco’s medium at 37 °C and 6% CO2. A paired comparison was performed referring to the fresh tissue of the same patient as control.
Main results and the role of chance
The histological evaluation performed after thawing revealed that follicles were predominantly primordial (91%), with no follicles larger than the proliferating primary stage. A significant reduction of follicular density per mm2 was observed in both study groups (14.2 ± 12.0 vs. 15.1 ± 14.0 for PROH+S and S Group, respectively; p = 0.4) compared to the fresh tissue (27.2 ± 31.6; p = 0.04) as well as a remarkable decreased of the proportion of intact follicles (39.3 ± 17.1 vs. 25.5 ± 9.8; p = 0.2) compared to the fresh tissue (98.1 ± 1.4; p = 0.002). Thawed samples equally showed interstitial oedema and increased stromal cell vacuolization and chromatin clumping. Ki67 positive staining of active proliferating cells revealed a comparable proportion of viable follicles between thawed samples (46.3 ± 20.8 vs. 28.3 ± 27.9 for PROH+S and S Group, respectively; p = 0.2). Finally, the expression of the endothelial marker CD31 in the thawed samples suggested an equivalent number of blood vessels per mm2 (43.8 ± 34.3 vs. 41.7 ± 44.8; p = 0.6).
Limitations, reasons for caution
Single centre study with a limited sample size. Only 24h of in vitro culture was assessed. The use of the freezing medium corresponding to the Sucrose only solution was not tested. Clinical outcomes after ovarian tissue transplantation should be evaluated before drawing final conclusion.
Wider implications of the findings
First evidence of the feasible application of a “Universal Warming” protocol, irrespective of brand and cryoprotectants, for the rapid thawing of slow-frozen human ovarian tissue. IVF centres would be provided with alternative options to thaw ovarian tissue for restoring reproductive potential in cancer patient undergoing ovarian transplantation.
Trial registration number
Not applicable
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Affiliation(s)
- S Canosa
- Livet, GeneraLife IVF , Turin, Italy
- Gynecology and Obstetrics 1U- Physiopathology of Reproduction and IVF Unit- S. Anna Hospital, Department of Surgical Sciences- University of Turin , Turin, Italy
| | - L Parmegiani
- GynePro Medical, NextClinics International- Reproductive Medicine Unit , Bologna, Italy
| | - F Evangelista
- Livet, GeneraLife IVF , Turin, Italy
- Gynecology and Obstetrics 1U- Physiopathology of Reproduction and IVF Unit- S. Anna Hospital, Department of Surgical Sciences- University of Turin , Turin, Italy
| | - S Durando
- Laboratory of Cytogenetics, Regina Margherita Hospital , Turin, Italy
| | - F Salvagno
- Gynecology and Obstetrics 1U- Physiopathology of Reproduction and IVF Unit- S. Anna Hospital, Department of Surgical Sciences- University of Turin , Turin, Italy
| | - M Sestero
- Gynecology and Obstetrics 1U- Physiopathology of Reproduction and IVF Unit- S. Anna Hospital, Department of Surgical Sciences- University of Turin , Turin, Italy
| | - D Cimadomo
- Clinica Valle Giulia, GeneraLife IVF , Rome, Italy
| | - A Vaiarelli
- Clinica Valle Giulia, GeneraLife IVF , Rome, Italy
| | - L Rienzi
- Clinica Valle Giulia, GeneraLife IVF , Rome, Italy
| | - F.M Ubaldi
- Clinica Valle Giulia, GeneraLife IVF , Rome, Italy
| | | | - A Revelli
- Gynecology and Obstetrics 2U- S. Anna Hospital, Department of Surgical Sciences- University of Turin , Turin, Italy
| | - G Gennarelli
- Gynecology and Obstetrics 1U- Physiopathology of Reproduction and IVF Unit- S. Anna Hospital, Department of Surgical Sciences- University of Turin , Turin, Italy
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Toto L, D'Aloisio R, De Nicola C, Evangelista F, Ruggeri ML, Cerino L, Simonelli MB, Aharrh-Gnama A, Di Nicola M, Porreca A, Mastropasqua R. Short-term comparison between navigated subthreshold microsecond pulse laser and oral eplerenone for chronic central serous chorioretinopathy. Sci Rep 2022; 12:4727. [PMID: 35304566 PMCID: PMC8933552 DOI: 10.1038/s41598-022-08764-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 03/10/2022] [Indexed: 11/23/2022] Open
Abstract
To compare the anatomical/functional changes after navigated subthreshold pulse laser (SML) and oral eplerenone therapy for chronic central serous chorioretinopathy (cCSC). A total of 36 eyes of 36 patients suffering from cCSC treated with navigated SML (Navilas® 577s; OD-OS GmbH, near Berlin, Germany) (18 eyes, SML group) and oral eplerenone (18 eyes, eplerenone group) were enrolled in this retrospective study. Main outcome measures during a 3-month follow up period included changes of best corrected visual acuity (BCVA), central macular thickness (CMT), foveal subretinal fluid thickness (FSRFT), and subfoveal choroidal thickness (SFCT). At baseline average duration of symptoms was 6.8 ± 0.6 months in SML group and 6.4 ± 0.9 months in eplerenone group (p = 0.127). Mean BCVA, CMT and FSRFT changed significantly over time (p < 0.001). From baseline to 90 days the BCVA improved from 0.3 ± 0.1 to 0.1 ± 0.1 logMAR in SML group and from 0.3 ± 0. to 0.2 ± 0.1 logMAR in eplerenone group, CMT reduced from 357.1 ± 104.3 to 210.6 ± 46.7 μm and from 428.7 ± 107.7 to 332.5 ± 27.5 μm in SML group and eplerenone group respectively, FSRFT reduced from 144.4 ± 108.2 to 22.6 ± 37.2 μm and from 217.1 ± 105.9 to 54.4 ± 86.2 μm in SML group and eplerenone group. 55.6% of patients in SML group and 66.7% in eplerenone group showed a complete resolution of FSRFT during follow up. The interaction between group and time was statistically significant with greater absolute variation for CMT and FSRFT in SML group compared to eplerenone group (p < 0.001 and p = 0.043). SFCT did not change significantly during follow up (p = 0.083) for both groups. Both navigated SML and oral eplerenone were effective treatments showing recovery of retinal morphology and related visual acuity improvement in cCSC.
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Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy.
| | - Chiara De Nicola
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Maria Ludovica Ruggeri
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Luca Cerino
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Maria Beatrice Simonelli
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Agbéanda Aharrh-Gnama
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Annamaria Porreca
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Via dei Vestini 31, 66100, Chieti, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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Appolloni R, Viggiano P, Carrella ML, Evangelista F, Appolloni A, Toto L, Mastropasqua L. Femto-assisted versus conventional phacoemulsification differently impact on choroid structure after surgery. Eur J Ophthalmol 2021; 32:2194-2200. [PMID: 34585600 DOI: 10.1177/11206721211048360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To report potential choroidal changes in eyes undergoing femtosecond laser cataract surgery (FLACS) and phacoemulsification surgery (PCS) by OCT. METHODS The patients were images by means Spectral Domain OCT imaging with EDI technology which may obtain OCT image. We exported a single EDI-OCT scan passing through the fovea and then it was imported into ImageJ program to perform a quantitative analysis. MAIN OUTCOME MEASURES The main outcome measures were: (i) sub foveal choroidal thickness (SFCT); (ii) the choroidal vascularity index (CVI); and (iii) central retinal thickness (CRT). RESULTS At postoperative 1 week, FLACS group showed an increased CRT (241.2 ± 31.6-245.5 ± 36.4 µm; p = 0.016). Likewise, CVI and SFCT exhibited a slight increase but no statistically differences were highlighted (p > 0.05). At the follow-up visit of 1 month, all OCT parameters did not display any significant difference (p > 0.05). At post-operative 1 week, the PCS group displayed a significant increase in CRT, SFCT, and CVI. On the contrary, at the follow-up visit of 1-month, all choroidal parameters were characterized by a no statistically significant reduction (p > 0.05). CONCLUSIONS Our study exhibited a significant increase in CT and CVI in eyes that underwent conventional cataract surgery. Femtosecond laser-assisted cataract extraction did not result in macular change due to less postoperative inflammation.
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Affiliation(s)
| | | | | | | | | | - Lisa Toto
- Gabriele d'Annunzio University of Chieti-Pescara, Chieti, Italy
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Viggiano P, Toto L, Ferro G, Evangelista F, Porreca A, Mastropasqua R. Choroidal structural changes in different intermediate AMD patterns. Eur J Ophthalmol 2021. [PMID: 33506710 DOI: 10.1177/1120672121992009.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To report variation of choroidal thickness (CT) and choroidal vascularity index (CVI) in subjects with drusen and subjects with reticular pseudodrusen (RPD) compared with healthy individuals using the Spectral-domain (SD)-Optical Coherence Tomography with enhanced depth imaging (EDI) system. DESIGN A prospective, observational, cross-sectional study. SUBJECTS Eighty-four participants. METHODS The patients were imaged using the Heidelberg Spectralis device (Heidelberg Engineering, Heidelberg, Germany) with EDI mode. EDI-OCT images were exported and then imported into image analysis ImageJ software (National Institutes of Health, Bethesda) and a semiautomated algorithm was used for subsequent quantitative analysis. MAIN OUTCOME MEASURES This study evaluated two choroidal parameters: (i) choroidal thickness (CT); (ii) choroidal vascularity index (CVI). RESULTS CT analysis was performed in three different regions: (i) foveal region, (ii) parafoveal region; (iii) perifoveal region. All the analyzed regions were significantly decreased in RPD pattern, as compared with both the drusen group (p < .005) and healthy eyes (p < .005). CVI was significantly decreased in the RPD pattern, as compared with healthy eyes (p < 0.001). However, the drusenoid pattern did not have statistical significance in comparison with the control group suggesting the lower incidence of this pattern on choroidal vasculopathy. CONCLUSIONS We report CT and CVI difference in RPD and drusen eyes. The RPD pattern seems to be a consequence of an alteration in the choroidal vascularity resulting in severe ischemia and excessive hypoxia inducing an increased risk of late AMD compared to the drusenoid pattern.
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Affiliation(s)
- Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Giada Ferro
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Annamaria Porreca
- Department of Economic Studies, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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Viggiano P, Toto L, Ferro G, Evangelista F, Porreca A, Mastropasqua R. Choroidal structural changes in different intermediate AMD patterns. Eur J Ophthalmol 2021; 32:460-467. [PMID: 33506710 DOI: 10.1177/1120672121992009] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE To report variation of choroidal thickness (CT) and choroidal vascularity index (CVI) in subjects with drusen and subjects with reticular pseudodrusen (RPD) compared with healthy individuals using the Spectral-domain (SD)-Optical Coherence Tomography with enhanced depth imaging (EDI) system. DESIGN A prospective, observational, cross-sectional study. SUBJECTS Eighty-four participants. METHODS The patients were imaged using the Heidelberg Spectralis device (Heidelberg Engineering, Heidelberg, Germany) with EDI mode. EDI-OCT images were exported and then imported into image analysis ImageJ software (National Institutes of Health, Bethesda) and a semiautomated algorithm was used for subsequent quantitative analysis. MAIN OUTCOME MEASURES This study evaluated two choroidal parameters: (i) choroidal thickness (CT); (ii) choroidal vascularity index (CVI). RESULTS CT analysis was performed in three different regions: (i) foveal region, (ii) parafoveal region; (iii) perifoveal region. All the analyzed regions were significantly decreased in RPD pattern, as compared with both the drusen group (p < .005) and healthy eyes (p < .005). CVI was significantly decreased in the RPD pattern, as compared with healthy eyes (p < 0.001). However, the drusenoid pattern did not have statistical significance in comparison with the control group suggesting the lower incidence of this pattern on choroidal vasculopathy. CONCLUSIONS We report CT and CVI difference in RPD and drusen eyes. The RPD pattern seems to be a consequence of an alteration in the choroidal vascularity resulting in severe ischemia and excessive hypoxia inducing an increased risk of late AMD compared to the drusenoid pattern.
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Affiliation(s)
- Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Giada Ferro
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Annamaria Porreca
- Department of Economic Studies, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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Borrelli E, Toto L, Viggiano P, Evangelista F, Palmieri M, Mastropasqua R. Widefield topographical analysis of the retinal perfusion and neuroretinal thickness in healthy eyes: a pilot study. Eye (Lond) 2020; 34:2264-2270. [PMID: 32055020 PMCID: PMC7784843 DOI: 10.1038/s41433-020-0804-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 10/31/2019] [Accepted: 11/16/2019] [Indexed: 01/22/2023] Open
Abstract
PURPOSE In this pilot study we reported variation of superficial (SCP) and deep (DCP) capillary plexuses flow in macular and near/mid periphery regions in healthy subjects using widefield swept source-optical coherence tomography angiography (SS-OCTA). METHODS In this prospective, cross-sectional study, enroled subjects were imaged with an SS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). OCTA scans were taken in primary and extremes of gaze and a montage was automatically created. Quantitative analysis was performed in the macular and peripheral regions. In addition, SCP and DCP variables were further investigated in distinct fields within these three different regions. RESULTS Fifty-five young healthy subjects (55 eyes) were enroled. The retinal periphery displayed a higher SCP perfusion density (39.6 ± 1.7% and 40.7 ± 1.4%, P < 0.0001) and SCP vessel diameter index (3.5 ± 0.2 and 3.6 ± 0.2, P < 0.0001), in comparison with the macular region. At the DCP level, the retinal periphery was characterized by a lower perfusion density (41.6 ± 3.7% and 37.9 ± 2.9%, P < 0.0001) and vessel length density (14.6 ± 6.0% and 9.9 ± 2.6%, P < 0.0001). In the analysis investigating the DCP in the retinal periphery, the temporal sector was characterized by a reduction in perfusion density, vessel length density, and vessel diameter index. In univariate analysis, the retinal thickness was found to have a significant direct relationship with DCP perfusion density (P < 0.0001), but not with SCP perfusion density (P = 0.712). CONCLUSIONS We report quantitative mapping of the SCP and DCP in healthy individuals. The DCP perfusion appears to have a wide topographical variation, which is strictly dependent on the retinal thickness.
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Affiliation(s)
- Enrico Borrelli
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Michele Palmieri
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
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Evangelista F, Hernandez S, Mambretti S, Parola D. Wave celerity in hydraulic transients computation for CIPP-rehabilitated pipes. Int J CMEM 2020. [DOI: 10.2495/cmem-v8-n4-326-340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Mastropasqua R, Evangelista F, Amodei F, D'Aloisio R, Pinto F, Doronzo E, Viggiano P, Porreca A, Di Nicola M, Parravano M, Toto L. Optical Coherence Tomography Angiography in Macular Neovascularization: A Comparison Between Different OCTA Devices. Transl Vis Sci Technol 2020; 9:6. [PMID: 33101783 PMCID: PMC7545059 DOI: 10.1167/tvst.9.11.6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 08/16/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study is to compare the ability of 3 optical coherence tomography angiography (OCTA) devices to measure lesion area in patients with macular neovascularization (MNV) with type 1, 2 and mixed neovascularization (NV). Methods OCTA, fluorescein angiography (FA), indocyanine green angiography (ICGA), and structural optical coherence tomography (OCT) were performed. NV lesion area measurements were performed by two graders. Results Twenty-eight eyes were included: 20 with NV were classified as type 1, 6 as type 2, and 2 as mixed type. AngioVue and Spectralis detected the NV in 26 out of 28 eyes (92.8%). The intraclass correlation coefficient (ICC) between readers for the three different OCTA with the different slabs was high. The NV area was larger in the outer retina to choriocapillaris (ORCC) and choriocapillaris (CC) images for the AngioVue device and the PLEX Elite device compared to avascular images (P < 0.05). The mean values of the NV area were not significantly different among the three instruments (Friedman test, P > 0.05) for the avascular zone (AV), ORCC, and CC images. Median (interquartile range [IQR]) NV were significantly different among avascular images, ORCC images, and CC images of the AngioVue device (P = 0.046), of the Spectralis device (P = 0.015), and the PLEX Elite device (P < 0.001). Conclusions The ORCC slabs showed the highest detection rate for NV detection independently to the device used, and swept source (SS)-OCTA measurements of ORCC slabs showed the highest detection rate of NVs compared to the spectral domain (SD)-OCTA. Translational Relevance It is pivotal to realize how much we can rely on OCTA to make a diagnosis of NV.
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Affiliation(s)
- Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Federica Evangelista
- Ophthalmic Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Francesco Amodei
- Ophthalmic Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Rossella D'Aloisio
- Ophthalmic Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Filomena Pinto
- Ophthalmic Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Emanuele Doronzo
- Ophthalmic Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Pasquale Viggiano
- Ophthalmic Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Annamaria Porreca
- Department of Economic Studies, University "G. D'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Marta Di Nicola
- Department of Economic Studies, University "G. D'Annunzio" Chieti-Pescara, Chieti, Italy
| | | | - Lisa Toto
- Ophthalmic Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
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Toto L, D'Aloisio R, Chiarelli AM, Di Antonio L, Evangelista F, D'Onofrio G, Merla A, Parravano M, Di Marzio G, Mastropasqua R. A Custom-Made Semiautomatic Analysis of Retinal Nonperfusion Areas After Dexamethasone for Diabetic Macular Edema. Transl Vis Sci Technol 2020; 9:13. [PMID: 32832220 PMCID: PMC7414703 DOI: 10.1167/tvst.9.7.13] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/29/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the changes of retinal capillary nonperfusion areas and retinal capillary vessel density of the superficial capillary plexus (SCP) and deep capillary plexus in patients with diabetes with diabetic macular edema treated with an intravitreal dexamethasone implant (IDI). Methods We enrolled 28 patients with diabetic retinopathy and diabetic macular edema candidates to IDI. All patients underwent widefield optical coherence tomography angiography with PLEX Elite 9000 device with 15 × 9 mm scans centered on the foveal center at baseline, 1 month, 2 months, and 4 months after IDI. In all the patients, the variation of the retinal capillary nonperfusion areas and of the retinal vessel density of the SCP and deep capillary plexus were calculated using an automatic software written in Matlab (MathWorks, Natick, MA). Results During follow-up, SCP showed a statistically significant reduction of ischemic areas at 1 month after IDI (P = 0.04) and slightly increased not significantly thereafter (P = 0.15). The percentage of nonperfusion areas changed from 11.4% at baseline, to 6.3% at 1 month, 8.1%, at 2 months, and 10.2% at 4 months. The whole vessel density of SCP slightly increased (not significantly) from 35.30% at baseline to 38.00% at 1 month, and then decreased to 37.85% at 2 months and 36.04% at 4 months (P = 0.29). Retinal capillary nonperfusion areas and retinal vessel density at the deep capillary plexus did not change significantly (P = 0.31 and P = 0.73, respectively). Conclusions Widefield optical coherence tomography angiography showed a decrease in retinal capillary nonperfusion areas after dexamethasone implant suggesting a possible drug-related reperfusion of retinal capillaries particularly evident in the early period. Translational Relevance A custom-made automatic analysis of retinal nonperfusion areas may allow a better and precise evaluation of ischemic changes after intravitreal therapy.
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Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Antonio Maria Chiarelli
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Giada D'Onofrio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Arcangelo Merla
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | | | - Guido Di Marzio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestini 31, 66100, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Via del Pozzo 71, 41125, Italy
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D’Aloisio R, Viggiano P, Borrelli E, Parravano M, Agbèanda AG, Evangelista F, Ferro G, Toto L, Mastropasqua R. Changes in Iris Perfusion Following Scleral Buckle Surgery for Rhegmatogenous Retinal Detachment: An Anterior Segment Optical Coherence Tomography Angiography (AS-OCTA) Study. J Clin Med 2020; 9:jcm9041231. [PMID: 32344742 PMCID: PMC7231266 DOI: 10.3390/jcm9041231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/19/2020] [Accepted: 04/21/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose: To investigate iris vasculature changes following scleral buckling (SB) surgery in eyes with rhegmatogenous retinal detachment (RRD) with anterior-segment (AS) optical coherence tomography angiography (OCTA). Methods: In this prospective study, enrolled subjects were imaged with an SS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). Image acquisition of the iris was obtained using an AS lens and a manual focusing adjustment in the iris using the retina imaging software. The quantitative analysis was performed in eight different iris regions: (i) superior, (ii) supero-temporal, (iii) supero-nasal, (iv) nasal, (v) temporal, (vi) inferior, (vii) infero-temporal, (viii) infero nasal which, were defined as squares with area of 1.5 mm2. Results: Fifteen eyes of 15 patients (six females; nine males) were included. Anterior segment optical coherence tomography angiography (AS-OCTA) parameters of the iris were statistically compared at baseline (preoperatively), 1 week, 1 month and 6 months after SB. At post-operative 1 week, perfusion density (PD) showed a significant decrease from 66.8 ± 13.2% to 58.55 ± 12.0% in the iris supero-nasal region (p = 0.016). However, at the 1-month follow-up visit, iris PD was significantly lower in all the analyzed iris regions, apart from the superior one. Conclusions: This study is the first description of AS-OCTA in patients undergoing SB. Our results showed a uniform reduction of the iris vessel network at 1 month after surgery, supporting the clinical use of AS-OCTA to identify early iris perfusion changes as potential predictive biomarkers of vascular disorders.
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Affiliation(s)
- Rossella D’Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (R.D.); (E.B.); (A.-G.A.); (F.E.); (G.F.); (L.T.)
| | - Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (R.D.); (E.B.); (A.-G.A.); (F.E.); (G.F.); (L.T.)
- Correspondence: ; Tel.: +39-08-7135-8410; Fax: +39-08-7135-7294
| | - Enrico Borrelli
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (R.D.); (E.B.); (A.-G.A.); (F.E.); (G.F.); (L.T.)
| | - Mariacristina Parravano
- IRCCS Fondazione G.B.Bietti per lo Studio e la Ricerca in Oftalmologia ONLUS, 00198 Roma, Italy;
| | - Aharrh-Gnama Agbèanda
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (R.D.); (E.B.); (A.-G.A.); (F.E.); (G.F.); (L.T.)
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (R.D.); (E.B.); (A.-G.A.); (F.E.); (G.F.); (L.T.)
| | - Giada Ferro
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (R.D.); (E.B.); (A.-G.A.); (F.E.); (G.F.); (L.T.)
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (R.D.); (E.B.); (A.-G.A.); (F.E.); (G.F.); (L.T.)
| | - Rodolfo Mastropasqua
- Facoltà di Medicina e Chirurgia dell’Università di Modena e Reggio Emilia, 41121 Modena, Italy;
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Borrelli E, Viggiano P, Evangelista F, Toto L, Mastropasqua R. Eyelashes Artifact in Ultra-Widefield Optical Coherence Tomography Angiography. Ophthalmic Surg Lasers Imaging Retina 2020; 50:740-743. [PMID: 31755975 DOI: 10.3928/23258160-20191031-11] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/26/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND OBJECTIVE To describe the presence of eyelashes artifact in ultra-widefield swept-source optical coherence tomography angiography (SS-OCTA) images. PATIENTS AND METHODS In this prospective, cross-sectional study, 52 healthy, young subjects were imaged with the SS-OCTA system. OCTA scans were taken in primary and extremes of gaze, and a montage was automatically created. The en face choriocapillaris images were then exported, and a semi-automated algorithm was used for subsequent quantitative analysis. RESULTS The authors noted the presence of some linear regions of reduced brightness, which were assumed to represent a shadow effect due to patient eyelashes. In order to quantify this effect, the authors performed a quantitative analysis of the superior and inferior regions in the retinal and choroidal vessels. CONCLUSIONS The authors' qualitative and quantitative analysis showed the presence of regions of false-positive hypoperfusion secondary to eyelashes artifacts. To the authors' knowledge, this represents the first description of this new type of shadowing artifact affecting OCTA images. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:740-743.].
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Toto L, Evangelista F, Viggiano P, Erroi E, D'Onofrio G, Libertini D, Porreca A, D'Aloisio R, Mariacristina P, Di Antonio L, Di Nicola M, Mastropasqua R. Changes in Ocular Blood Flow after Ranibizumab Intravitreal Injection for Diabetic Macular Edema Measured Using Laser Speckle Flowgraphy. Biomed Res Int 2020; 2020:9496242. [PMID: 32104710 PMCID: PMC7035512 DOI: 10.1155/2020/9496242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the effects of intravitreal ranibizumab (IVR) treatment on the blood flow of the optic nerve head (ONH) and of retinal vessels of the peripapillary region of eyes with diabetic macular edema (DME) assessed using laser speckle flowgraphy (LSFG). METHODS Forty eyes of 30 patients treated with IVR for DME were included in this prospective clinical study. Mean blur rate (MBR) and relative flow volume (RFV) of the ONH and of a superior retinal artery and an inferior retinal vein of the peripapillary region were measured using LSFG at baseline, 2 weeks (T1), and 1 month (T2) after IVR injection. In addition, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were measured in all cases. RESULTS The BCVA improved and CRT decreased significantly during the follow-up period (p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA. CONCLUSION IVR injection leads to a reduction of ocular blood flow both in the ONH and in the retinal peripapillary vessels associated with peripapillary vessel constriction. The reduction of CRT and related improvement of vision may be related to the changes in ocular blood flow.
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Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Emanuele Erroi
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Giada D'Onofrio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Daniele Libertini
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Annamaria Porreca
- Department of Economic Studies, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | | | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Via dei Vestini 31, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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Mastropasqua R, Viggiano P, Borrelli E, Evangelista F, Libertini D, Di Antonio L, Toto L. In Vivo Mapping of the Choriocapillaris in High myopia: a Widefield Swept Source Optical Coherence Tomography Angiography. Sci Rep 2019; 9:18932. [PMID: 31831754 PMCID: PMC6908654 DOI: 10.1038/s41598-019-55192-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 11/18/2019] [Indexed: 01/08/2023] Open
Abstract
To report variation of choriocapillaris (CC) flow in widefield in high in myopic subjects compared with an age-matched normal control group using ultra widefield optical coherence tomography angiography (UW-OCTA). This is a Prospective, cross-sectional study. Thirty high myopia subjects and fifty healthy subjects were enrolled. Healthy and high myopia subjects were imaged with the SS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). For each eye, five 12 × 12-mm OCTA volume scans were acquired. The en face CC images were then exported to imageJ and a semi-automated algorithm was used for subsequent quantitative analysis. The main outcome was a quantitative analysis of the CC. This analysis was performed in three different regions: (i) peripapillary, (ii) macular, and (iii) periphery. In addition, CC variables were further investigated in distinct fields within these three different regions. Thirty myopic eyes (32 subjects; myopic group) and fifty eyes (50 subjects; control group) without elevated myopia were included in the analysis. Mean ± SD age was 26.9 ± 2.9 years [median: 27 years; range: 20.0–40.0 years]. Mean ± SD axial length was 26.6 ± 0.6 mm [median: 26.2 mm; range: 26.1 to 28.0 mm]. Mean ± SD axial length was 26.6 ± 0.6 mm [median: 26.2 mm; range: 26.1 to 28.0 mm] in the myopic group and 23.9 ± 1.1 mm [median: 23.9 mm; range: 21.8 to 25.9 mm] in the control group. The total signal void area was significantly greater in myopic eyes compared with control group. The peripapillary region exhibited the greatest total signal void area (p < 0.0001 vs macular region, p < 0.0001 vs peripheral region). Within the macular region, the foveal area exhibited a greater total signal void area in comparison with both the parafoveal area (p < 0.0001) and the perifoveal area (p < 0.0001). In conclusion we report quantitative mapping of the choriocapillaris in myopic eyes compared with an age-matched normal control group. The CC perfusion appears to have a wide topographical variation.
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Affiliation(s)
| | - Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
| | - Enrico Borrelli
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Daniele Libertini
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
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Mastropasqua R, D'Aloisio R, Di Antonio L, Erroi E, Borrelli E, Evangelista F, D'Onofrio G, Di Nicola M, Di Martino G, Toto L. Widefield optical coherence tomography angiography in diabetic retinopathy. Acta Diabetol 2019; 56:1293-1303. [PMID: 31468199 DOI: 10.1007/s00592-019-01410-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 08/19/2019] [Indexed: 11/27/2022]
Abstract
AIMS To evaluate superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris (CC) perfusion in macular and near/mid periphery regions in diabetic patients using widefield swept-source optical coherence tomography angiography (WSS-OCTA). METHODS Ninety-four diabetic patients (94 eyes) classified as diabetics without diabetic retinopathy (no DR) (25 eyes), mild DR (23 eyes), moderate/severe DR (26 eyes), proliferative DR (20 eyes) and a control group of 25 healthy subjects (25 eyes) were imaged with the WSS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). Quantitative analysis was performed in the macular and peripheral regions. The main outcome measures were perfusion density (PD) and vessel length density of SCP, DCP and CC. RESULTS Peripheral retina (all sectors) showed lower SCP and DCP PD compared to the macular region (p < 0.001). In diabetics without DR and DR in different stages, SCP and DCP PD significantly decreased at advancing stages of DR (p < 0.001). At DCP level, central PD was significantly directly related to peripheral PD (superior, R = 0.682 and 0.479; temporal, R = 0.918 and 0.554; inferior, R = 0.711). A good sensitivity and an excellent specificity were found in terms of prediction of disease worsening, especially for central and temporal sectors in all plexuses and for all sectors both central and peripheral of DCP. CONCLUSIONS The widefield OCTA is useful for the study of central and peripheral retina in diabetic patients with or without diabetic retinopathy, assessing good correlation between central and peripheral retina.
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Affiliation(s)
- Rodolfo Mastropasqua
- Vitreoretinal Unit, Bristol Eye Hospital, University of Bristol, Bristol, UK
- Eye Clinic, Polytechnic University of Marche, 60126, Ancona, Italy
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy.
| | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Emanuele Erroi
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Enrico Borrelli
- Department of Ophthalmology, University Vita Salute, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Giada D'Onofrio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, 66100, Chieti, Italy
| | - Giuseppe Di Martino
- Department of Medicine and Science of Ageing, School of Hygiene and Preventive Medicine, University G. d'Annunzio Chieti-Pescara, 66100, Chieti, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
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Toto L, Viggiano P, Vecchiarino L, Evangelista F, Borrelli E, Mastropasqua L. Anterior capsule contraction syndrome: a successful multimodal therapeutic approach. Int J Ophthalmol 2019; 12:1356-1358. [PMID: 31456930 DOI: 10.18240/ijo.2019.08.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/23/2019] [Indexed: 11/23/2022] Open
Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti 66100, Italy
| | - Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti 66100, Italy
| | - Luca Vecchiarino
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti 66100, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti 66100, Italy
| | - Enrico Borrelli
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti 66100, Italy
| | - Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti 66100, Italy
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Borrelli E, Uji A, Toto L, Viggiano P, Evangelista F, Mastropasqua R. In Vivo Mapping of the Choriocapillaris in Healthy Eyes: A Widefield Swept-Source OCT Angiography Study. Ophthalmol Retina 2019; 3:979-984. [PMID: 31371198 DOI: 10.1016/j.oret.2019.05.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 05/01/2019] [Accepted: 05/24/2019] [Indexed: 01/18/2023]
Abstract
PURPOSE To report variation of choriocapillaris flow in peripapillary, macular, and near- and mid-periphery regions in healthy participants using widefield swept-source (SS) OCT angiography (OCTA). DESIGN Prospective, cross-sectional study. PARTICIPANTS Fifty healthy participants. METHODS Healthy young participants were imaged with the SS OCTA system (PLEX Elite 9000; Carl Zeiss Meditec, Inc, Dublin, CA). OCT angiography scans were obtained in primary and extreme gazes and a montage was created automatically. The en face choriocapillaris images then were exported to ImageJ software version 1.50 (National Institutes of Health, Bethesda, MD), and a semiautomated algorithm was used for subsequent quantitative analysis. MAIN OUTCOME MEASURES Quantitative analysis of the choriocapillaris performed in 3 different regions: (1) peripapillary, (2) macular, and (3) periphery. In addition, choriocapillaris variables were investigated further in distinct fields within these 3 different regions. RESULTS Fifty eyes (50 participants) were included in the analysis. Mean age ± standard deviation was 25.2±5.1 years (median, 24.5 years; range, 20.0-40.0 years). The peripapillary region exhibited the greatest total signal void area (P < 0.0001 vs. the macular region; P < 0.0001 vs. the peripheral region). Within the macular region, the foveal area exhibited a greater total signal void area in comparison with both the parafoveal area (P = 0.009) and the perifoveal area (P = 0.015). In the analysis investigating the near- and mid-periphery region, the temporal sector was characterized by a lower total signal void area compared with both the superior and inferior areas (P = 0.016 and P = 0.003, respectively). CONCLUSIONS We report quantitative mapping of the choriocapillaris in healthy individuals. Choriocapillaris perfusion seems to have a wide topographic variation.
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Affiliation(s)
- Enrico Borrelli
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
| | - Akihito Uji
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Bristol Eye Hospital, University Hospitals NHS Foundation Trust, Bristol, United Kingdom
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Toto L, D'Aloisio R, Mastropasqua R, Di Antonio L, Di Nicola M, Di Martino G, Evangelista F, Erroi E, Doronzo E, Mariotti C. Anatomical and Functional Changes of the Retina and the Choroid after Resolved Chronic CSCR. J Clin Med 2019; 8:jcm8040474. [PMID: 30959979 PMCID: PMC6517936 DOI: 10.3390/jcm8040474] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 03/28/2019] [Accepted: 04/04/2019] [Indexed: 11/22/2022] Open
Abstract
Background: To investigate anatomical/functional changes after oral eplerenone therapy for chronic central serous chorioretinopathy (CCSC) in successfully treated eyes and fellow eyes and assess timing of foveal subretinal fluid (SRF) resolution. Methods: Twenty-one eyes of 21 patients suffering from CCSC with monolateral foveal SRF successfully treated with oral eplerenone were enrolled in this retrospective study (group 1). The fellow eyes (21 eyes; group 2), healthy or affected by CCSC, without foveal SRF were considered in the analysis. A control healthy group was enrolled as well (healthy controls; n = 21). Main outcome measures during follow-up included changes of best corrected visual acuity (BCVA, logMAR), central macular thickness (CMT; µm), SRF (µm), subfoveal choroidal thickness (SFCT; µm), superficial capillary plexus density (SCPD, %), deep capillary plexus density (DCPD, %), and choriocapillaris density (CCD, %) and percentage of eyes showing foveal SRF resolution at different time points. Results: Functional and anatomical parameters significantly improved during the study in group 1. BCVA increased significantly (p < 0.001), while CMT, SFCT, and SRF decreased significantly (p < 0.001; p < 0.001, and p = 0.037, respectively). SCPD, DCPD, and CCD did not show any statistically significant difference during follow-up. In 71.4% of eyes, resolution of SRF was observed within 60 days and in the remaining 28.6%, at 120 days. In fellow eyes, SFCT decreased significantly (p < 0.001), whilst all other parameters did not modify. Conclusions: Eplerenone treatment in chronic CSCR potentially improves recovery of retinal and choroidal morphology as well as visual acuity gain. A complete resolution of foveal SRF was observed in all eyes during a 4-month follow-up, with most eyes healing at 2 months.
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Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
| | - Rodolfo Mastropasqua
- Vitreoretinal Unit, Bristol Eye Hospital, University of Bristol, Bristol, BS1 4TB, UK.
- Eye Clinic, Polytechnic University of Marche, 60126 Ancona, Italy.
| | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy.
| | - Giuseppe Di Martino
- Department of Medicine and Science of Ageing, School of Hygiene and Preventive Medicine, University G. d'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
| | - Emanuele Erroi
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
| | - Emanuele Doronzo
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
| | - Cesare Mariotti
- Eye Clinic, Polytechnic University of Marche, 60126 Ancona, Italy.
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Prisayanh P, Evangelista F, Roth A, Temple B, Li N, Qian Y, Culton D, Liu Z, Harrison O, Brasch J, Honig B, Shapiro L, Diaz L. 039 Pathogenic IgG4 anti-Dsg1 autoantibodies from endemic pemphigus foliaceus inhibit the heterophilic Dsg1/Dsc1 adhesive interactions. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abdolrahimzadeh S, Parisi F, Plateroti AM, Evangelista F, Fenicia V, Scuderi G, Recupero SM. Visual Acuity, and Macular and Peripapillary Thickness in High Myopia. Curr Eye Res 2017; 42:1468-1473. [DOI: 10.1080/02713683.2017.1347692] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Solmaz Abdolrahimzadeh
- Ophthalmology Unit, Azienda Ospedaliera Universitaria Policlinico Umberto I, University of Rome “Sapienza”, Rome, Italy
| | - Francesco Parisi
- Ophthalmology Unit, Azienda Ospedaliera Universitaria Policlinico Umberto I, University of Rome “Sapienza”, Rome, Italy
| | - Andrea Maria Plateroti
- Ophthalmology Unit, Azienda Ospedaliera Universitaria Policlinico Umberto I, University of Rome “Sapienza”, Rome, Italy
| | - Federica Evangelista
- Ophthalmology Unit, Azienda Ospedaliera Universitaria Policlinico Umberto I, University of Rome “Sapienza”, Rome, Italy
| | - Vito Fenicia
- Ophthalmology Unit, St. Andrea Hospital, NESMOS Department, University of Rome “Sapienza”, Rome, Italy
| | - Gianluca Scuderi
- Ophthalmology Unit, St. Andrea Hospital, NESMOS Department, University of Rome “Sapienza”, Rome, Italy
| | - Santi Maria Recupero
- Ophthalmology Unit, St. Andrea Hospital, NESMOS Department, University of Rome “Sapienza”, Rome, Italy
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Bertero A, Ritrovato F, Evangelista F, Stabile V, Fortina R, Ricci A, Revelli A, Vincenti L, Nervo T. Evaluation of equine oocyte developmental competence using polarized light microscopy. Reproduction 2017; 153:775-784. [PMID: 28283673 DOI: 10.1530/rep-17-0125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 03/03/2017] [Accepted: 03/09/2017] [Indexed: 12/28/2022]
Abstract
The purpose of this study was to observe in vitro-matured equine oocytes with an objective computerized technique that involves the use of a polarized light microscope (PLM) in addition to the subjective morphological evaluation obtained using a classic light microscope (LM). Equine cumulus-oocyte complexes (COCs, n = 922) were subjected to different in vitro maturation times (24, 36 or 45 h), however, only 36-h matured oocytes were analyzed using CLM. The 36-h matured oocytes that reached maturity were parthenogenetically activated to evaluate the quality and meiotic competence. Average maturation percentages per session in groups 1, 2 and 3 (24-, 36- and 45-h matured oocytes respectively) were 29.31 ± 13.85, 47.01 ± 9.90 and 36.62 ± 5.28%, whereas the average percentages of immature oocytes per session were 28.78 ± 20.17, 7.83 ± 5.51 and 22.36 ± 8.39% respectively. The zona pellucida (ZP) birefringent properties were estimated and correlated with activation outcome. ZP thickness and retardance of the inner layer of the zona pellucida (IL-ZP) were significantly increased in immature oocytes compared with mature oocytes (P < 0.001 and P < 0.01 respectively). The comparison between parthenogenetically activated and non-activated oocytes showed a significant increase in the area and thickness of the IL-ZP in parthenogenetically activated oocytes (P < 0.01). These results show that the 36-h in vitro maturation (IVM) protocol allowed equine oocytes to reach maturity, and PLM observation of ZP can be used to distinguish mature and immature oocytes as well as activated and non-activated oocytes.
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Affiliation(s)
- A Bertero
- Department of Veterinary ScienceUniversity of Torino, Grugliasco, Italy
| | - F Ritrovato
- Department of Surgical SciencesUniversity of Torino, S. Anna Hospital, Torino, Italy
| | - F Evangelista
- Department of Surgical SciencesUniversity of Torino, S. Anna Hospital, Torino, Italy
| | - V Stabile
- Department of Surgical SciencesUniversity of Torino, S. Anna Hospital, Torino, Italy
| | - R Fortina
- Department of AgriculturalForestry and Food Sciences, University of Torino, Grugliasco, Italy
| | - A Ricci
- Department of Veterinary ScienceUniversity of Torino, Grugliasco, Italy
| | - A Revelli
- Department of Surgical SciencesUniversity of Torino, S. Anna Hospital, Torino, Italy
| | - L Vincenti
- Department of Veterinary ScienceUniversity of Torino, Grugliasco, Italy
| | - T Nervo
- Department of Veterinary ScienceUniversity of Torino, Grugliasco, Italy
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Revelli A, Rovei V, Dalmasso P, Gennarelli G, Racca C, Evangelista F, Benedetto C. Large randomized trial comparing transabdominal ultrasound-guided embryo transfer with a technique based on uterine length measurement before embryo transfer. Ultrasound Obstet Gynecol 2016; 48:289-95. [PMID: 26924732 DOI: 10.1002/uog.15899] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 02/19/2016] [Accepted: 02/22/2016] [Indexed: 05/10/2023]
Abstract
OBJECTIVE To compare in a randomized, non-inferiority trial the embryo transfer (ET) technique based on uterine length measurement before transfer (ULMbET) with transabdominal ultrasound-guided embryo transfer (TA-UGET) in a large population of patients undergoing in-vitro fertilization (IVF). METHODS Patients undergoing IVF with ET with cleaving fresh embryos were randomized to receive ULMbET or TA-UGET. The transfer of one to three embryos on day 2-3 of culture was performed using a soft catheter either under transabdominal ultrasound guidance (TA-UGET group) or after measurement of the uterine cavity by transvaginal ultrasound and calculation of the discharge site (ULMbET group). The primary outcome measures were clinical pregnancy rate, ongoing pregnancy rate and implantation rate, and secondary outcomes included patient discomfort during ET. RESULTS A total of 1648 patients undergoing IVF were randomized to receive ULMbET (n = 828) or TA-UGET (n = 820) and were included in the analysis. Comparable clinical pregnancy rate (38.2% vs 38.9%), implantation rate (24.8% vs 25.2%) and ongoing pregnancy rate (33.1% vs 34.8%) were observed in ULMbET and TA-UGET groups. The discomfort intensity score and the proportion of patients with moderate-to-severe discomfort during ET were significantly higher in the TA-UGET group (2.6 vs 1.5 visual analog scale points and 19.8% vs 1.2%; P = 0.045 and P = 0.003, respectively). CONCLUSION The ULMbET technique leads to IVF results comparable to those obtained with UGET, but is better tolerated than is TA-UGET and is technically easier to perform for a single operator. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- A Revelli
- Gynecology and Obstetrics 1U, Physiopathology of Reproduction and IVF Unit, Sant'Anna Hospital, University of Turin, Turin, Italy.
| | - V Rovei
- Gynecology and Obstetrics 1U, Physiopathology of Reproduction and IVF Unit, Sant'Anna Hospital, University of Turin, Turin, Italy
| | - P Dalmasso
- Medical Statistics Unit, Department of Public Health and Microbiology, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - G Gennarelli
- Gynecology and Obstetrics 1U, Physiopathology of Reproduction and IVF Unit, Sant'Anna Hospital, University of Turin, Turin, Italy
| | - C Racca
- Gynecology and Obstetrics 1U, Physiopathology of Reproduction and IVF Unit, Sant'Anna Hospital, University of Turin, Turin, Italy
| | - F Evangelista
- Gynecology and Obstetrics 1U, Physiopathology of Reproduction and IVF Unit, Sant'Anna Hospital, University of Turin, Turin, Italy
| | - C Benedetto
- Gynecology and Obstetrics 1U, Physiopathology of Reproduction and IVF Unit, Sant'Anna Hospital, University of Turin, Turin, Italy
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Abstract
Every day patients on peritoneal dialysis (PD) must focus on their dialysis schedules and on nutritional and therapeutic prescriptions. Unfortunately, over time all these actions may not follow the initial protocol. In order to evaluate patient's knowledge and approach to dialysis, an alternative educational tool to hospital or home was investigated. The campus was utilised as a place for re-training and detecting and correcting discrepancies in knowledge and the management of techniques. A continuous educational programme involves some re-training of PD patients and this approach helps us to identify whether the treatment management at home is in accordance with the information given at the start of the dialysis, but there was a need to improve on this and to improve patient understanding and compliance. The campus was chosen as an alternative educational process with the aim of involving the patients themselves and their families to achieve additional benefits and long-term success of the therapy. This initiative, outside the hospital and in collaboration with professional figures not affiliated with the dialysis unit, hoped to offer patients new knowledge about: dialysis technique and procedures, prevention of infectious complications, nutrition and physical activity.
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Affiliation(s)
- N Zuccherato
- 'San Giacomo Apostolo' Hospital, Nephrology and Dialysis Unit, Castelfranco Veneto (TV), Italy
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Nilson K, Åhlund J, Shariati MN, Schiessling J, Palmgren P, Brena B, Göthelid E, Hennies F, Huismans Y, Evangelista F, Rudolf P, Göthelid M, Mårtensson N, Puglia C. Potassium-intercalated H2Pc films: Alkali-induced electronic and geometrical modifications. J Chem Phys 2012; 137:044708. [PMID: 22852645 DOI: 10.1063/1.4738755] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Nilson
- Department of Physics, Uppsala University, Box 530, S-751 21 Uppsala, Sweden
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Evangelista F, Ruocco A, Gotter R, Cossaro A, Floreano L, Morgante A, Crispoldi F, Betti MG, Mariani C. Electronic states of CuPc chains on the Au(110) surface. J Chem Phys 2009; 131:174710. [DOI: 10.1063/1.3257606] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cossaro A, Cvetko D, Bavdek G, Floreano L, Gotter R, Morgante A, Evangelista F, Ruocco A. Copper−Phthalocyanine Induced Reconstruction of Au(110). J Phys Chem B 2004. [DOI: 10.1021/jp049108h] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. Cossaro
- Laboratorio TASC dell'Istituto Nazionale per la Fisica della Materia, Basovizza SS-14, Km 163.5, I-34012 Trieste, Italy, Department of Physics, University of Ljubljana, Ljubljana, Slovenia, Jožef Stefan Institute, Ljubljana, Slovenia, Department of Physics, University of Trieste, Trieste, Italy, INFM unit of Roma Tre and Physics Department, University of Roma Tre, Via della Vasca Navale 84, 00146 Roma, Italy
| | - D. Cvetko
- Laboratorio TASC dell'Istituto Nazionale per la Fisica della Materia, Basovizza SS-14, Km 163.5, I-34012 Trieste, Italy, Department of Physics, University of Ljubljana, Ljubljana, Slovenia, Jožef Stefan Institute, Ljubljana, Slovenia, Department of Physics, University of Trieste, Trieste, Italy, INFM unit of Roma Tre and Physics Department, University of Roma Tre, Via della Vasca Navale 84, 00146 Roma, Italy
| | - G. Bavdek
- Laboratorio TASC dell'Istituto Nazionale per la Fisica della Materia, Basovizza SS-14, Km 163.5, I-34012 Trieste, Italy, Department of Physics, University of Ljubljana, Ljubljana, Slovenia, Jožef Stefan Institute, Ljubljana, Slovenia, Department of Physics, University of Trieste, Trieste, Italy, INFM unit of Roma Tre and Physics Department, University of Roma Tre, Via della Vasca Navale 84, 00146 Roma, Italy
| | - L. Floreano
- Laboratorio TASC dell'Istituto Nazionale per la Fisica della Materia, Basovizza SS-14, Km 163.5, I-34012 Trieste, Italy, Department of Physics, University of Ljubljana, Ljubljana, Slovenia, Jožef Stefan Institute, Ljubljana, Slovenia, Department of Physics, University of Trieste, Trieste, Italy, INFM unit of Roma Tre and Physics Department, University of Roma Tre, Via della Vasca Navale 84, 00146 Roma, Italy
| | - R. Gotter
- Laboratorio TASC dell'Istituto Nazionale per la Fisica della Materia, Basovizza SS-14, Km 163.5, I-34012 Trieste, Italy, Department of Physics, University of Ljubljana, Ljubljana, Slovenia, Jožef Stefan Institute, Ljubljana, Slovenia, Department of Physics, University of Trieste, Trieste, Italy, INFM unit of Roma Tre and Physics Department, University of Roma Tre, Via della Vasca Navale 84, 00146 Roma, Italy
| | - A. Morgante
- Laboratorio TASC dell'Istituto Nazionale per la Fisica della Materia, Basovizza SS-14, Km 163.5, I-34012 Trieste, Italy, Department of Physics, University of Ljubljana, Ljubljana, Slovenia, Jožef Stefan Institute, Ljubljana, Slovenia, Department of Physics, University of Trieste, Trieste, Italy, INFM unit of Roma Tre and Physics Department, University of Roma Tre, Via della Vasca Navale 84, 00146 Roma, Italy
| | - F. Evangelista
- Laboratorio TASC dell'Istituto Nazionale per la Fisica della Materia, Basovizza SS-14, Km 163.5, I-34012 Trieste, Italy, Department of Physics, University of Ljubljana, Ljubljana, Slovenia, Jožef Stefan Institute, Ljubljana, Slovenia, Department of Physics, University of Trieste, Trieste, Italy, INFM unit of Roma Tre and Physics Department, University of Roma Tre, Via della Vasca Navale 84, 00146 Roma, Italy
| | - A. Ruocco
- Laboratorio TASC dell'Istituto Nazionale per la Fisica della Materia, Basovizza SS-14, Km 163.5, I-34012 Trieste, Italy, Department of Physics, University of Ljubljana, Ljubljana, Slovenia, Jožef Stefan Institute, Ljubljana, Slovenia, Department of Physics, University of Trieste, Trieste, Italy, INFM unit of Roma Tre and Physics Department, University of Roma Tre, Via della Vasca Navale 84, 00146 Roma, Italy
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Orazi S, Evangelista F, Menè A, Romeo F, Venturini D, Riva U. 17.7 A pragmatic approach for a safe programming of biventricular stimulators: Preliminary data of a prospective study. Europace 2003. [DOI: 10.1016/eupace/4.supplement_1.a29-d] [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: 10/14/2022] Open
Affiliation(s)
- S. Orazi
- Cardiology Department, General Hospital di Rieti, Italy
| | | | - A. Menè
- Cardiology Department, General Hospital di Rieti, Italy
| | - F. Romeo
- Cardiology Department, Tor Vergata University, Italy
| | | | - U. Riva
- Vitatron Medical Italia, Italy
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Vaudo G, Schillaci G, Evangelista F, Pasqualini L, Verdecchia P, Mannarino E. Arterial wall thickening at different sites and its association with left ventricular hypertrophy in newly diagnosed essential hypertension. Am J Hypertens 2000; 13:324-31. [PMID: 10821331 DOI: 10.1016/s0895-7061(99)00229-0] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The impact of hypertension on vascular structure at different arterial sites and the relation of vascular hypertrophy with left ventricular (LV) hypertrophy in the early stages of essential hypertension are unclear. In 96 newly diagnosed, never-treated, uncomplicated hypertensive subjects aged < 55 years (43 +/- 9 years, 68 men, clinic blood pressure 152/99 mm Hg, 24-h blood pressure 135/89 mm Hg), we measured LV mass (M-mode echocardiography) and intima-media thickness (IMT) of the carotid and femoral arteries (high-resolution B-mode ultrasound). The average of 24 carotid and 24 femoral IMT readings (common and internal carotid or common and superficial femoral, right and left side, far and near wall, three sampling points per segment) was analyzed. Carotid and femoral IMT were strongly related to each other (r = 0.77). Subjects with LV hypertrophy (n = 33) had a greater IMT at the carotid (0.84 +/- 0.2 v 0.71 +/- 0.2 mm, P < .0001) and femoral (0.77 +/- 0.1 v 0.64 +/- 0.1 mm, P < .0001) level. Carotid IMT showed a positive correlation with LV mass (r = 0.46) and age (r = 0.38), and an inverse one with high-density lipoprotein (HDL) cholesterol (r = -0.26). Femoral IMT was associated positively to LV mass (r = 0.50), age (r = 0.33) and triglycerides (r = 0.29), and inversely to HDL-cholesterol (r = -0.33). The association between IMT (both carotid and femoral) and LV mass held after controlling for age and other confounders in a multiple regression analysis. In summary, in the early stages of hypertension arterial wall thickening appears to be a diffuse process, which occurs in parallel at the carotid and femoral level and shows a positive association with LV hypertrophy.
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Affiliation(s)
- G Vaudo
- Sezione di Medicina Interna, Angiologia e Malattie da Arteriosclerosi, University of Perugia, and the Azienda Ospedaliera di Perugia, Italy
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Reynolds DL, Evangelista F, Ward BM, Notenboom RH, Young ER, D'Cunha CO. Syphilis in an urban community. Can J Public Health 1998; 89:248-52. [PMID: 9735518 PMCID: PMC6990170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Recent reports of changes in the epidemiology of syphilis prompted a review of syphilis in our urban community. All records of positive syphilis serology reported to the City of Scarborough Health Department between 1990-94 were reviewed for key epidemiological variables. While infectious stages of syphilis were reported more often among young adults, incidence for all stages increased among successive age groups, with a male/female ratio of 1.0. One in five cases were identified during immigration screening, with a disproportionate number of cases immigrating from the Caribbean, Africa and Subcontinental India. Overall, the incidence of syphilis decreased during the study. However, a correlation of 0.95 was found between the provincial incidence of syphilis and number of tests ordered. The observed decrease in syphilis, therefore, may represent a decrease in detection owing to lack of testing.
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Affiliation(s)
- D L Reynolds
- Community Medicine Residency, University of Toronto.
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Walsh SV, Evangelista F, Khettry U. Inflammatory myofibroblastic tumor of the pancreaticobiliary region: morphologic and immunocytochemical study of three cases. Am J Surg Pathol 1998; 22:412-8. [PMID: 9537467 DOI: 10.1097/00000478-199804000-00004] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare tumor of the pancreaticobiliary region. The etiology and biologic behavior of IMTs at this site are unknown. We present three patients with IMT of the pancreaticobiliary region, each with long-term follow-up. In all three cases a second tumor developed. Grossly these tumors mimicked a malignant process. Microscopically, all were composed of an admixture of spindle cells and chronic inflammatory cells, including plasma cells, lymphocytes, eosinophils, and macrophages. The spindle cells stained positively for smooth muscle actin and vimentin but were negative for S-100, cytokeratin, CD35, and latent membrane protein. Results of in situ hybridization with EBER probes were negative in all cases. In addition to carcinoma, the differential diagnosis of these tumors includes follicular dendritic cell tumor and inflammatory fibrosarcoma. The importance of extensive pathologic examination to prevent misdiagnosis and the need for long-term follow-up are emphasized. This subset of IMT does not appear to be related to Epstein-Barr virus.
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Affiliation(s)
- S V Walsh
- Harvard Medical School, and Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA
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