1,721,013 research outputs found
Central Retinal Vein Occlusion and Prothrombotic Factors
No full textRetinal vein occlusion (RVO) is an important cause of visual loss.
Known risk factors are hypertension, diabetes mellitus, hyperlipidaemia, open angle glaucoma and abnormalities of haemostatic factors and blood viscosity.
The aim of our study was to identify any relationships between RVO and fibrinolytic-coagulative pattern in patients affected either by metabolic disorders or not
Methods: 50 patients (22 male, 28 female) affected by RVO underwent a study of metabolic, coagulative and fibrinolytic parameters.
All patients were not submitted to any previous ocular theraphy before the episode of RVO.
After a complete ophtalmologic evaluation, blood was collected to perform various laboratory tests:
Enzymatic-colorimetric: glicaemia, total-cholesterol (TC), HDL-cholesterol (HDL-C), Tryglicerides (TG), Antitrombin III (ATIII), Protein C and S (PC, PS), Alpha-2-antiplasmin (A2P), Plasminogen (PL). ELISA: D-dimer (DD), tissue plasminogen activator and inhibitor (t-PA, PAI-1), thrombin activable fibrinolysis inhibitor (TAFI), Soluble P and E selectin (sP-sel, sE-sel), vonWillebrand factor (vWF), fragment 1+2 (F1+2), lipoprotein (a) [lp(a)]. Coagulative: Protein C resistance (APCR), Factor VII and VIII (VII, VIII). HPLC: Homocysteine.
Our data show a decreased fibrinolytic power in 43/50 subjects (86%) (ELT 318±36 min, PAP 107±19 ug/l).
PAI-1 was 21.4±4.2 UI/l in the general population with differences between diabetic and dyslipidaemic subjects and not-metabolic patients.
1 patients suffered from low ATIII levels (60%), none had PC, PS deficiency or APCR.
2 not-metabolic subjects had increased Lp (a) and impairment of fibrinolysis.
Hyper Hc (21.6±3.1umol/l) was detected in 4 subjects
TAFI and sP-sel were increased in patients (4) with type IIa hyperlipidemia.
sE-sel and vWF were particularly increased in dysmetabolic subjects (diabetes and Hyper TG or low HDL-C).
A prothrombotic state involving defects in coagulative and fibrinolytic factors has been previously associated with the onset of RVO.
Our data show that a fibrinolytic impairment is the most common feature in such patients regardless dysmetabolic or not associated diseases.
Moreover mechanisms leading to fybrinolysis alterations vary between subjects in order to associated metabolic conditions.
Defects in anticoagulant natural proteins or platelet hyperactivity are very rare conditions detected in our population.
Such data suggest that the fibrinolytic system may be an important target of acute treatment and profilaxys in RVO affected patients
The immunopathology of keratoconus: tear film biomarkers and immune pathways
No full textPurpose of review This review explores established risk factors for keratoconus and current insights into tear film immune biomarkers, with a focus on the role of chronic low-grade inflammation in disease pathogenesis and emerging targeted therapies. Recent findings Growing evidence supports immune dysregulation as a key driver in the onset and progression of keratoconus. Genetics establish a foundation for a dysregulated inflammatory response in the ocular surface and corneal microenvironment, which sustains and accelerates disease progression. Elevated tear levels of IL-1, IL-6, TNF-α, HMGB1, and MMP9 reflect these inflammatory changes. Chronic inflammation and repeated mechanical trauma from eye rubbing, especially in adolescents and young adults, are major risk factors for disease progression. Timely screening and regular corneal topography in adolescents with allergic or atopic disorders are essential for early diagnosis and prevention of vision loss. Summary The tear film and corneal microenvironment contain valuable immune markers that shed light on keratoconus pathophysiology. Advances in precision and predictive medicine hold promise for safer, more effective strategies to halt disease progression
Ciliary Body and Iris Melanocytoma in a 2-Year-Old Boy
No full textA 2-year-old boy presented with mild ocular pain and hyperemia in the left eye for 6 months; visual acuity was 20/200. The patient had no medical history of trauma or surgery. Slit-lamp examination showed sectorial hyperemia and a black lesion of the left eye from 5–7 o’clock (A). Fundus examination revealed choroidal pigmented dome-shaped mass contacting the posterior capsular bag from 4–8 o’clock (B). Orbital magnetic resonance imaging demonstrated, in T1-weighted images, a hyperintense retrolental mass with cystic components infiltrating the ciliary body (C). Enucleation was performed; histopathologic examination revealed hyperpigmented epithelioid melanocytes within the ciliary body, confirming the diagnosis of melanocytom
New generation analysis of thrombin generation in retinal vein thrombosis
Full text linkPurpose
To investigate potential mechanisms involved in retinal vein occlusion (RVO) we evaluated thrombin generation and soluble CD40 ligand (sCD40L) with respect to other known thrombophilic factors.
Methods
68 patients affected by RVO (28 central, 40 branch) and 60 healthy controls were evaluated for endogenous thrombin potential (ETP) by a chromogenic method and sCD40L by ELISA technique. Polymerase chain reaction (PCR) was employed for genetic polymorphisms and coagulative/chromogenic methods for othe coagulation factors.
Results
Independently of genetic polymorphisms ETP was increased in patients with CRVO whereas sCD40L was higher in the whole cohort.
Conclusions
Our data indicate an involvement of global coagulative activation in CRVO patients as suggested by ETP
Ultrasound biomicroscophy in the diagnosis and management of ciliary body traumatic avulsion
No full textSicurezza ed efficacia della i-lasik con femtolaser e “side cut” invertito: nostra esperienza
No full textCoagulative, fibrinolytic and metabolic pattern in patients with central retinal vein occlusion
No full textCentral retinal vein occlusion (CRVO) is an important cause of visual loss. Many risk factors have been associated with CRVO onset at various ages. Among them diabetes mellitus, hypertension, immunologic disorders, increase in blood viscosity and coagulation, decrease of fibrinolysis have been reported in many subjects. The aim of our study was to detect the metabolic, coagulative and fibrinolytic pattern in 54 patients (26 men, 28 women, mean age 50.4 ± 12.3) affected by CRVO. We excluded from the study patients with other ocular disorders. A fibrinolytic impairment is the most common feature in our population. It occurs either in dysmetabolic or in nonmetabolic subjects. Such data suggest a prominent role of the fibrinolytic system in the pathogenesis of CRVO
Isolated noncompaction of ventricular myocardium in an adult patient with mild dysmorphisms.
No full textMEDICAL TREATMENT OF CRVO
No full textPurpose:
A disorder of fibrinolytic power is a risk factor for both venous and arterial thrombosis. An hypofibrinolytic state has been described as a common feature in Central Retinal Vein Occlusion (CRVO) affected subjects. Aim of our study was to evaluate the efficacy of a thrombotic-risk assessement related therapy either in acute phase treatment or secondary prophylaxis in CRVO affected patients.
Methods:
Phase A: 60 subjects (28 female, 22 male) were respectively treated with ASA 325 mg/die (19), heparin 12500 to 25000 U/die (16) , and mesoglycan 100 mg/die (25) for one month. Phase B: 35 subjects were treated with ASA 325 mg/die for 6 months and 29 patients with mesoglycan 100 mg/die. The development of new thrombotic events was assessed by fundoscopy at one and six months.
Results:
In phase A 5/19 (26%) subjects in the ASA, 6/16 (37%) in the heparin and 2/25 (8%) (p< 0.001) in the mesoglycan group experienced a new thrombotic event. In phase B 13/35 (37%) in the ASA and 3/29 (10%) (p< 0.001) in the mesoglycan group showed new thrombotic signs.
Conclusions:
Our data suggest that a profibrinolytic treatment in thrombotic risk-profile selected subjects is safe and effective for the therapy and prophylaxis of CRVO when compared to other antithrombotic agents
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