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Gelormini F, Parisi G, Vallino V, Ricardi F, Marolo P, Borrelli E, Reibaldi M. Pitchfork sign following pars Plana vitrectomy for idiopathic epiretinal membrane: A case report. Eur J Ophthalmol 2024; 34:NP92-NP96. [PMID: 38409823 DOI: 10.1177/11206721241234426] [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] [Indexed: 02/28/2024]
Abstract
PURPOSE To report a case of pitchfork sign following pars plana vitrectomy for idiopathic epiretinal membrane. STUDY DESIGN Case report. RESULTS A 75-year-old man was referred to the surgical retina service due to a quantitative and qualitative decline in vision in the left eye (LE) for several months. Optical coherence tomography (OCT) examination revealed the presence of a stage III epiretinal membrane (ERM) according to the Govetto classification. Seven days after undergoing a 25-gauge pars plana vitrectomy (PPV) with ERM peeling and balanced salt solution (BSS) tamponade, OCT examination revealed the presence of the 'pitchfork sign' in the macular region, along with the detection of a choroidal neovascularization (CNV) through OCT-A examination. After receiving two monthly intravitreal anti-VEGF injections, a complete regression of the MNV was observed. CONCLUSIONS We reported, for the first time, the iatrogenic onset of the pitchfork sign following vitreoretinal surgery. This discovery highlights the unique presentation of the pitchfork sign in the context of surgical procedures, expanding our comprehension of its range of causes.
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Affiliation(s)
| | | | | | | | - Paola Marolo
- Department of Ophthalmology, University of Turin, Turin, Italy
| | - Enrico Borrelli
- Department of Ophthalmology, University of Turin, Turin, Italy
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Ricardi F, Reccalenda I, Boscia G, Gelormini F, Cimorosi F, Novarese C, Marolo P, Parisi G, Bandello F, Borrelli E, Reibaldi M. Retinal OCT biomarkers associated with reading performance in patients with persistent vs. resolved diabetic macular edema. Eur J Ophthalmol 2024:11206721241248682. [PMID: 38632942 DOI: 10.1177/11206721241248682] [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: 04/19/2024]
Abstract
BACKGROUND Recent advancements in imaging technologies, particularly structural optical coherence tomography (OCT), have improved the understanding of diabetic macular edema (DME) pathophysiology and provided valuable biomarkers for disease progression and visual outcomes. This prospective study aimed to investigate the association between specific retinal biomarkers identified through OCT imaging and reading performance metrics in patients with previously treated persistent versus resolved DME and good visual acuity. METHODS Forty-nine eyes from 35 patients with a history of DME were enrolled. Reading performance was assessed using the Radner reading charts, which include standardized sentences with geometrically progressing print sizes. Structural alterations in the inner and outer retina, as well as the retinal pigment epithelium (RPE), were graded based on OCT images. RESULTS Reading performance, measured as maximum reading speed, was associated with specific retinal biomarkers. The disruption of the ellipsoid zone (EZ) in the parafoveal region and the presence of disorganization of the inner retinal layers (DRIL) in the parafovea were correlated with reduced reading speed. These associations were independent of the presence of intraretinal or subretinal fluid. CONCLUSIONS Understanding the relationship between retinal biomarkers and reading performance could contribute to a comprehensive evaluation of visual function and quality of life in patients with DME, leading to better management strategies and treatment outcomes.
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Affiliation(s)
| | | | - Giacomo Boscia
- Department of Basic Medical Sciences, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | | | | | | | - Paola Marolo
- Department of Ophthalmology, University of Turin, Turin, Italy
| | | | - Francesco Bandello
- Vita-Salute San Raffaele University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Enrico Borrelli
- Department of Ophthalmology, University of Turin, Turin, Italy
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Boscia G, Ricardi F, Gelormini F, Marica V, Conte F, Ghilardi A, Viggiano P, Marolo P, Bandello F, Borrelli E, Reibaldi M. INTERSESSION REPEATABILITY OF READING PERFORMANCE MEASURES IN PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION. Retina 2024; 44:707-713. [PMID: 38064659 DOI: 10.1097/iae.0000000000004015] [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: 03/28/2024]
Abstract
PURPOSE To assess the intersession repeatability of reading performance measures in patients with previously treated neovascular age-related macular degeneration and good best-corrected visual acuity (≥20/40 Snellen). METHODS Ninety-one patients (91 eyes) with a diagnosis of previously treated neovascular age-related macular degeneration and good best-corrected visual acuity (≥20/40 Snellen) were prospectively enrolled. Reading performance metrics were assessed using Radner charts, and these measurements were repeated after 7 days to obtain the intersession repeatability. To test repeatability, we calculated the intraclass correlation coefficient, the 95% coefficient of repeatability, and the coefficient of variation for each reading parameter: 1) reading acuity (RA-LogRAD); 2) maximal reading speed-words per minute; 3) RA score (RA score-LogRAD); and 4) critical print size-LogRAD. RESULTS Mean ± standard deviation best-corrected visual acuity was 0.13 ± 0.01 logMAR [range: 0.00-0.30 logMAR]. The intraclass correlation coefficient values indicated a good reliability for all the analyzed metrics (0.901 for RA; 0.859 for max reading speed; 0.906 for RA score; and 0.868 for critical print size). The coefficient of repeatability was 0.2 LogRAD for RA, 63.2 words per minute for max reading speed, 0.2 LogRAD for RA score, and 0.2 LogRAD for critical print size. Coefficient of variation was 5.5% for RA, 8.9% for max reading speed, 5.8% for RA score, and 6.9% for critical print size. CONCLUSION Reading performance metrics are characterized by good values of intersession repeatability in patients with neovascular age-related macular degeneration with good best-corrected visual acuity. Our findings may grant the employment of such measures in trials assessing the visual outcome in these patients.
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Affiliation(s)
| | | | | | | | - Fabio Conte
- Department of Ophthalmology, University of Turin, Italy
| | | | - Pasquale Viggiano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Paola Marolo
- Department of Ophthalmology, University of Turin, Italy
| | - Francesco Bandello
- Vita-Salute San Raffaele University Milan, Italy; and
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Enrico Borrelli
- Vita-Salute San Raffaele University Milan, Italy; and
- IRCCS San Raffaele Scientific Institute, Milan, Italy
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Borrelli E, Barresi C, Ricardi F, Berni A, Grosso D, Viggiano P, Marolo P, Introini U, Reibaldi M, Bandello F. Distinct Pathways of Macular Atrophy in Type 3 Macular Neovascularization Associated With AMD. Invest Ophthalmol Vis Sci 2024; 65:18. [PMID: 38470327 PMCID: PMC10939139 DOI: 10.1167/iovs.65.3.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/25/2024] [Indexed: 03/13/2024] Open
Abstract
Purpose To explore the occurrence of macular atrophy (MA) in eyes with age-related macular degeneration (AMD)-associated Type 3 macular neovascularization (MNV) treated with anti-vascular endothelial growth factor (anti-VEGF) therapy. Importantly, we aimed at describing the existence of separate pathways leading to MA. Methods We analyzed 41 participants (41 eyes) with treatment-naïve Type 3 MNV who were followed up for a duration of 12 months after beginning the anti-VEGF therapy. At the one-year follow-up visit, optical coherence tomography (OCT) scans were reviewed for the presence of MA. MA regions of interest (ROIs) were selected and traced back to their original dominant baseline lesion (i.e., precursor) through previous serially captured OCT scans. Baseline lesions included precursors associated with the development and exudation of MNV and causes external to the neovascularization itself. Results At the one-year follow-up visit, MA was graded to be present in 38 (92.7%) out of 41 eyes. These 78 MA ROIs were divided into two subgroups according to the precursor lesion, yielding a group of 53 MA lesions with precursors associated with the development and exudation of MNV (i.e., MA caused by physical harm from Type 3 neovessels, collapse of a serous pigment epithelium detachment, and fibrosis) and 25 MA regions with precursors external to the neovascularization itself (i.e., MA caused by drusen or subretinal drusenoid deposits). Conclusions Eyes with Type 3 MNV are commonly complicated by MA and precursors of MA include causes associated with the development and exudation of MNV, as well as lesions unrelated to the neovascularization process itself.
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Affiliation(s)
| | - Costanza Barresi
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | | | - Alessandro Berni
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Domenico Grosso
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Pasquale Viggiano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy
| | - Paola Marolo
- Department of Ophthalmology, University of Turin, Turin, Italy
| | - Ugo Introini
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Francesco Bandello
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
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Parisi G, Gelormini F, Ricardi F, Borrelli E, Parisi F, Belluardo G, Azzaro L, Marolo P, D'antico S, Salafia M, Reibaldi M. Platelet rich plasma for primary macular hole: A case series. Eur J Ophthalmol 2024:11206721241234419. [PMID: 38425189 DOI: 10.1177/11206721241234419] [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: 03/02/2024]
Abstract
OBJECTIVE To evaluate the anatomical and functional macular results and rate of complications following surgical treatment of primary macular hole (MH) with autologous platelet rich plasma (a-PRP) use. DESIGN retrospective, interventional, non-randomized case series. PARTECIPANTS AND METHODS A cohort of 9 consecutive patients from January 1, 2019 to August 31, 2021 who underwent vitrectomy with a-PRP use for primary MH were included. Anatomical results based on spectral domain- optical coherence tomography (SD-OCT) and visual acuity were analyzed. RESULTS 10 pseudophakic eye of 9 patients were enrolled. Six patients were female and three patients were male. The mean age was 69.9 years ± 1.48. The baseline MH minimum diameter was 486.1 μm ± 37.1, and mean pre operative best-corrected visual acuity (BCVA) was 0.91 ± 0.03 logMAR (Snellen equivalent 20/160). Mean 1 month post operative BCVA was 0.81 ± 0.57 logMAR (Snellen equivalent 20/130; p = 1.000); mean 3 month post operative BCVA was 0.66 ± 0.04 logMAR (Snellen equivalent 20/90; p = 0.006); mean 6 month post operative BCVA was 0.6 ± 0.04 logMAR (Snellen equivalent 20/80; p < 0.001). In all eyes, 10/10 (100%), there was a complete MH closure at 6 months follow up: 5 eyes (50%) with a U-type closure pattern, 4 eyes (40%) with a V-type pattern and 1 eye (10%) with an irregular foveal contour closure at 6 month follow-up. No ocular and systemic complications were reported. CONCLUSION The a-PRP use is a successful and promising vitreoretinal surgical technique option for primary MH.
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Affiliation(s)
- Guglielmo Parisi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy
| | - Francesco Gelormini
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy
| | - Federico Ricardi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy
| | - Enrico Borrelli
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy
| | - Francesca Parisi
- Department of ophthalmology, Provincial Health Agency of Ragusa 7, Ragusa, Italy
| | - Giuseppe Belluardo
- Department of ophthalmology, Provincial Health Agency of Ragusa 3, Caltagirone, Italy
| | - Laura Azzaro
- Department of ophthalmology, Provincial Health Agency of Ragusa 7, Ragusa, Italy
| | - Paola Marolo
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy
| | | | | | - Michele Reibaldi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy
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Gelormini F, D'antico S, Ricardi F, Parisi G, Borrelli E, Marolo P, Conte F, Salafia M, Reibaldi M. Platelet concentrates in macular hole surgery. A journey through the labyrinth of terminology, preparation, and application: a comprehensive review. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-023-06365-x. [PMID: 38270630 DOI: 10.1007/s00417-023-06365-x] [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: 08/24/2023] [Revised: 12/16/2023] [Accepted: 12/28/2023] [Indexed: 01/26/2024] Open
Abstract
The surgical management of macular holes is undergoing continuous evolution, with recent focus on the utilization of platelet concentrates as a promising adjunctive intervention. Currently, they present a valid surgical approach for achieving anatomical and functional success with a non-inferiority comparably to the alternative surgical techniques. Nonetheless, the utilization of varied platelet concentrates terminologies, coupled with the lack of standardization in their preparation methodologies, engenders both lexical confusion and challenges in comparing scientific studies published up until now. In this review, we summarized the published evidence concerning the application of platelet concentrates in macular holes surgery, aiming to clarify the terminology and methodologies employed and to establish a common consensus facilitating further development and diffusion of this promising technique.
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Affiliation(s)
- Francesco Gelormini
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122, Turin, Italy
| | - Sergio D'antico
- Blood Bank, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Federico Ricardi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122, Turin, Italy.
| | - Guglielmo Parisi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122, Turin, Italy
| | - Enrico Borrelli
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122, Turin, Italy
| | - Paola Marolo
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122, Turin, Italy
| | - Fabio Conte
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122, Turin, Italy
| | - Marika Salafia
- Blood Bank, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Michele Reibaldi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122, Turin, Italy
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Ricardi F, Borrelli E, Boscia G, Gelormini F, Marica V, Conte F, Viggiano P, Marolo P, Bandello F, Reibaldi M. Relationship of Topographic Distribution of Macular Atrophy Secondary to Neovascular AMD and Reading Performance. Invest Ophthalmol Vis Sci 2024; 65:44. [PMID: 38289615 PMCID: PMC10833051 DOI: 10.1167/iovs.65.1.44] [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: 05/01/2023] [Accepted: 01/05/2024] [Indexed: 02/01/2024] Open
Abstract
Purpose The purpose of this study was to provide a topographical assessment of macular atrophy in successfully treated neovascular age-related macular degeneration (AMD) eyes to investigate determinants of monocular reading performance. Methods A total of 60 participants (60 eyes) with previously treated neovascular AMD and absence of optical coherence tomography (OCT) signs of exudation were enrolled. Reading performance was assessed monocularly using Radner charts. The following variables were obtained: (i) the reading acuity was defined as the logarithm of the reading acuity determination (LogRAD), at the smallest sentence, a patient is able to read in less than 30 seconds; (ii) the maximum reading speed was defined as the fastest time achieved and is calculated in words per minute (wpm). OCT images were reviewed for the presence of macular atrophy within the central, 4 inner and 4 outer Early Treatment Diabetic Retinopathy Study (ETDRS) grid subfields. Contributory factors affecting reading performance were examined using univariable and multivariable linear mixed model considering reading acuity and reading speed as dependent variables. Results Median (interquartile range [IQR]) values were 0.53 (IQR = 0.17) LogRAD for reading acuity, and 144 (60) wpm for maximum reading speed. Thirty-five out of 60 (58.3%) eyes were characterized by the presence of macular atrophy. In multiple regression analysis, reading acuity was significantly associated with presence of macular atrophy in the foveal central circle (P = 0.024). Conversely, the maximum reading speed was associated with presence of macular atrophy in the inner-right ETDRS subfield (P = 0.005). Conclusions We showed a significant relationship between presence and location of macular atrophy and reading performance in neovascular AMD.
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Affiliation(s)
- Federico Ricardi
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Ophthalmology, “City of Health and Science” Hospital, Turin, Italy
| | - Enrico Borrelli
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Ophthalmology, “City of Health and Science” Hospital, Turin, Italy
| | - Giacomo Boscia
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Ophthalmology, “City of Health and Science” Hospital, Turin, Italy
| | - Francesco Gelormini
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Ophthalmology, “City of Health and Science” Hospital, Turin, Italy
| | - Valentina Marica
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Ophthalmology, “City of Health and Science” Hospital, Turin, Italy
| | - Fabio Conte
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Ophthalmology, “City of Health and Science” Hospital, Turin, Italy
| | - Pasquale Viggiano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy
| | - Paola Marolo
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Ophthalmology, “City of Health and Science” Hospital, Turin, Italy
| | - Francesco Bandello
- Vita-Salute San Raffaele University, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Michele Reibaldi
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Ophthalmology, “City of Health and Science” Hospital, Turin, Italy
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Spinetta R, Petrillo F, Reibaldi M, Tortori A, Mazzoni M, Metrangolo C, Gelormini F, Ricardi F, Giordano A. Intravitreal DEX Implant for the Treatment of Diabetic Macular Edema: A Review of National Consensus. Pharmaceutics 2023; 15:2461. [PMID: 37896220 PMCID: PMC10610055 DOI: 10.3390/pharmaceutics15102461] [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: 08/01/2023] [Revised: 09/16/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
Diabetic macular edema (DME)'s therapeutic approach can frequently be challenging. The purpose of the review is to propose evidence-based recommendations on the employment of intravitreal dexamethasone implants (DEX) when approaching patients suffering from DME. Seven national consensuses redacted by different groups of retina specialists from Europe and Asia were examined and confronted. Each consensus was redacted utilizing a Delphi approach, in person meetings, or by reviewing the literature. DEX can be studied as a first-line strategy in individuals suffering from DME with inflammatory OCT biomarkers, in vitrectomized eyes, in patients with recent cardiovascular events, in pregnant women, in patients scheduled to undergo cataract surgery or with poor compliance. The other parameters considered were the indications to the DME treatment, when to switch to DEX, the definition of non-responder to anti-VEGFs agents and to the DEX implant, whether to combine DEX with laser photocoagulation, the association between glaucoma and DEX, and the management of DEX and the cataract. Although several years have passed since the introduction of DEX implants in the DME treatment, there is still not a unified agreement among retina specialists. This paper compares the approach in the DME treatment between countries from different continents and provides a broader and worldwide perspective of the topic.
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Affiliation(s)
| | - Francesco Petrillo
- Department of Medical Sciences, Eye Clinic, Turin University, 10024 Turin, Italy; (M.R.); (F.G.); (F.R.)
| | - Michele Reibaldi
- Department of Medical Sciences, Eye Clinic, Turin University, 10024 Turin, Italy; (M.R.); (F.G.); (F.R.)
| | - Antonia Tortori
- Ophthalmology Unit, Surgery Department, Piacenza Hospital, 29121 Piacenza, Italy;
| | - Maria Mazzoni
- University Center for Studies on Gender Medicine, University of Ferrara, 44124 Ferrara, Italy;
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy
| | - Cristian Metrangolo
- Ophthalmology Unit, Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, 21100 Varese, Italy;
| | - Francesco Gelormini
- Department of Medical Sciences, Eye Clinic, Turin University, 10024 Turin, Italy; (M.R.); (F.G.); (F.R.)
| | - Federico Ricardi
- Department of Medical Sciences, Eye Clinic, Turin University, 10024 Turin, Italy; (M.R.); (F.G.); (F.R.)
| | - Antonio Giordano
- Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA;
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Borrelli E, Barresi C, Battista M, Berni A, Ricardi F, Cascavilla ML, Reibaldi M, Bandello F. PREVALENCE AND MORPHOLOGIC BIOMARKERS OF METAMORPHOPSIA IN EYES WITH "RESOLVED" CHRONIC CENTRAL SEROUS CHORIORETINOPATHY. Retina 2023; 43:1563-1572. [PMID: 37229754 DOI: 10.1097/iae.0000000000003845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE To assess relationships between demographics, clinical characteristics, and optical coherence tomography characteristics with persistence of metamorphopsia after resolution of subretinal fluid in eyes with chronic central serous chorioretinopathy. METHODS One-hundred participants with "resolved" (absence of subretinal fluid) chronic central serous chorioretinopathy were retrospectively analyzed. Patients underwent a complete ophthalmologic evaluation, including assessment of the presence of metamorphopsia. At the study visit, optical coherence tomography scans were reviewed for qualitative and quantitative features. RESULTS Sixty-six of 100 patients (66.0%) complained of metamorphopsia. Both the foveal and parafoveal ganglion cell complex thicknesses were thinner in central serous chorioretinopathy eyes with metamorphopsia (35.1 ± 10.6 µ m and 82.0 ± 18.1 µ m vs. 40.7 ± 11.8 µ m and 93.1 ± 13.5 µ m, P = 0.030 and P < 0.0001). In the foveal region, the outer plexiform layer and outer nuclear layer thicknesses were thinner in patients with metamorphopsia (24.6 ± 8.5 µ m and 63.1 ± 20.9 µ m vs. 29.1 ± 8.7 and 76.2 ± 18.2 µ m, P = 0.016 and P = 0.005). The ellipsoid zone band was more frequently discontinued in eyes with metamorphopsia (56.1% vs. 35.3%, P = 0.039). Multivariate stepwise linear regression analysis demonstrated that the strongest associations with the presence of metamorphopsia were with parafoveal ganglion cell complex thickness ( P = 0.004), foveal outer nuclear layer thickness ( P = 0.010), and number of previous recurrences of subretinal fluid accumulation ( P = 0.017). The time interval from the last subretinal fluid resolution was not associated with the presence of metamorphopsia. CONCLUSION In "resolved" central serous chorioretinopathy, clinical aspects (i.e., number of previous recurrences) and structural changes (i.e., ganglion cell complex and outer nuclear layer thinning) are associated with metamorphopsia after subretinal fluid resolution.
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Affiliation(s)
- Enrico Borrelli
- Vita-Salute San Raffaele University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy; and
| | - Costanza Barresi
- Vita-Salute San Raffaele University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy; and
| | - Marco Battista
- Vita-Salute San Raffaele University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy; and
| | - Alessandro Berni
- Vita-Salute San Raffaele University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy; and
| | - Federico Ricardi
- Vita-Salute San Raffaele University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy; and
| | - Maria Lucia Cascavilla
- Vita-Salute San Raffaele University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy; and
| | | | - Francesco Bandello
- Vita-Salute San Raffaele University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy; and
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Fea AM, Ricardi F, Cariola R, Rossi A. Hydrus microstent for the treatment of primary open-angle glaucoma: overview of its safety and efficacy. Expert Rev Med Devices 2023; 20:1009-1025. [PMID: 37752854 DOI: 10.1080/17434440.2023.2259788] [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: 05/11/2023] [Accepted: 09/13/2023] [Indexed: 09/28/2023]
Abstract
INTRODUCTION Minimally invasive glaucoma surgeries (MIGS) are now a consolidated reality in many surgical units. The Hydrus Microstent is one of several MIGS devices bypassing trabecular outflow and had excellent results over the years. This article aims to review the key features of the Hydrus Microstent in terms of design, efficacy, and safety. AREAS COVERED The present review analyses the main characteristics of the device by evaluating the technical and physical details of its functioning. The evidence that supports a clinical decision summarizes the most influential clinical trials and the most accurate systematic reviews. EXPERT OPINION The Hydrus device has been extensively studied regarding biocompatibility and outflow potential. The subsequent clinical studies have been well-built and proved that the device effectively reduces intraocular pressure (IOP) and the eyedrop load. The device covers almost a quarter of Schlemm's canal circumference, offering at least two advantages: cannulating the Schlemm's canal provides evidence that the device has been implanted correctly; covering a larger area potentially allows to target multiple collector channels or at least areas of active outflow. This scaffold may prove more effective in naïve patients or subjects who used antiglaucoma eyedrops for a limited period, as the prolonged use of hypotonic medications has been associated with the surgical failure of ab interno microhook trabeculotomy.
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Affiliation(s)
- Antonio M Fea
- Institute of Ophthalmology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Federico Ricardi
- Institute of Ophthalmology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Rossella Cariola
- Institute of Ophthalmology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Alessandro Rossi
- Institute of Ophthalmology, Department of Surgical Sciences, University of Turin, Turin, Italy
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Parisi G, Ricardi F, Boscia G, Ghilardi A, Gelormini F, Marolo P, Fallico M, D’Antico S, Salafia M, Reibaldi M. Macula-Off Retinal Detachment with Refractory Macular Hole Previously Closed with Autologous Platelet-Rich Plasma: A Case Report. Case Rep Ophthalmol 2023; 14:462-468. [PMID: 37901644 PMCID: PMC10601804 DOI: 10.1159/000530199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/07/2023] [Indexed: 10/31/2023] Open
Abstract
The purpose of this report was to present a case of a refractory full-thickness macular hole (FTMH) complicated with recurrent retinal detachment (RD) previously treated with an autologous platelet-rich plasma (aPRP) plug. A 65-year-old male patient presented to our department with a FTMH, RD, and a giant retinal break. Preoperative best corrected visual acuity (BCVA) was 1.40 logMAR (20/500). A 25-G pars plana vitrectomy (PPV) was performed, with peripheral retinal-breaks laser barrage, peeling of the internal limiting membrane, and silicon oil injection. One month later, spectral domain optical coherence tomography (SD-OCT) showed the persistence of the FTMH with a diameter of 712 μm. Therefore, the patient underwent silicon oil removal and aPRP injection with good anatomical outcome and improvement of BCVA to 0.6 log-MAR (20/80). Two months later a recurrence of macula-off RD was detected, but SD-OCT showed that the aPRP plug was still in place and kept the two margins of the macular hole together. The patient underwent a further PPV with silicon oil injection and subsequent silicon oil removal with no postoperative complications. Two months later, the retina remained attached, SD-OCT confirmed FTMH closure and BCVA was 0.52 logMAR (20/63). In conclusion, this case report aims to underline the remarkable efficacy of aPRP in promoting FTMH closure, which was maintained despite subsequent recurrence of macula-off RD.
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Affiliation(s)
- Guglielmo Parisi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy
| | - Federico Ricardi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy
| | - Giacomo Boscia
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy
| | - Andrea Ghilardi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy
| | - Francesco Gelormini
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy
| | - Paola Marolo
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy
| | - Matteo Fallico
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Sergio D’Antico
- Blood Bank, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Marika Salafia
- Blood Bank, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Michele Reibaldi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy
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Nuzzi R, Boscia G, Marolo P, Ricardi F. The Impact of Artificial Intelligence and Deep Learning in Eye Diseases: A Review. Front Med (Lausanne) 2021; 8:710329. [PMID: 34527682 PMCID: PMC8437147 DOI: 10.3389/fmed.2021.710329] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/23/2021] [Indexed: 12/21/2022] Open
Abstract
Artificial intelligence (AI) is a subset of computer science dealing with the development and training of algorithms that try to replicate human intelligence. We report a clinical overview of the basic principles of AI that are fundamental to appreciating its application to ophthalmology practice. Here, we review the most common eye diseases, focusing on some of the potential challenges and limitations emerging with the development and application of this new technology into ophthalmology.
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Affiliation(s)
- Raffaele Nuzzi
- Ophthalmology Unit, A.O.U. City of Health and Science of Turin, Department of Surgical Sciences, University of Turin, Turin, Italy
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Fauri JAC, Ricardi F. P16 protein expression in primary cutaneous melanoma with positive and negative lymph node biopsies: Particular aspects of a study performed at the Hospital de Clinicas de Porto Alegre, Brazil. Plast Surg (Oakv) 2011. [DOI: 10.4172/plastic-surgery.1000707] [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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Fauri JAC, Ricardi F, Diehl ES, Cartell A, Furian R, Bakos L, Edelweiss MI. P16 protein expression in primary cutaneous melanoma with positive and negative lymph node biopsies: Particular aspects of a study performed at the Hospital de Clinicas de Porto Alegre, Brazil. Can J Plast Surg 2011; 19:77-81. [PMID: 22942654 PMCID: PMC3269325 DOI: 10.1177/229255031101900313] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cutaneous melanoma dermal invasion, identified through measurement of maximum tumour thickness and sentinel lymph node (SLN) biopsy, is important to establish melanoma prognosis and progression. P16 protein expression has been shown to be a predictive factor for melanoma evolution and prognosis. OBJECTIVE To investigate p16 protein expression in cutaneous melanomas with and without SLN metastasis. PATIENTS AND METHODS Sixty-seven paraffin-embedded cutaneous melanoma specimens of patients who had undergone SLN investigation were evaluated from 1995 to 2007. SLN biopsy was negative for metastasis in 34 of these patients (controls); in the remaining 33 patients, SLN biopsy was positive (cases). The expression of p16 protein in the primary tumour was measured using an immunohistochemical assay. The samples were classified according to their nuclear expression. RESULTS P16 nuclear expression was absent in 14 cases and in 15 controls; P=0.812. There was no statistically significant difference in p16 nuclear expression between cases and controls. CONCLUSIONS The present study does not support the findings of other studies that suggest p16 protein expression is important in the prognosis of cutaneous melanoma.
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Affiliation(s)
- JAC Fauri
- Department of Surgery, Programa de pós graduação em Ciências Cirúrgicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul
| | - F Ricardi
- Department of Pathology, Fundação Faculdade Federal de Ciências Médicas de Porto Alegre
| | | | - A Cartell
- Department of Pathology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul and Hospital de Clínicas de Porto Alegre
| | - R Furian
- Department of Pathology, Fundação Faculdade Federal de Ciências Médicas de Porto Alegre and Hospital Santa Casa de Misericórdia de Porto Alegre
| | - L Bakos
- Department of Dermatology Service, Faculdade de Medicina
| | - MI Edelweiss
- Department of Pathology, Universidade Federal do Rio Grande do Sul and Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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