1,720,972 research outputs found
RNFL Study in Graves Orbitopathy
No full textPurpose:to determine changes of retinal nerve fiber layer (RNFL) in a group of patients with serious thyroid-related immune orbitopathy and compare it with a group of patients with moderate Graves orbitopathy.
Methods:in this study, 17 eyes of 9 patients with severe Graves orbitopathy (Group 1) and 12 eyes of 6 patients with moderate Graves orbitopathy (Group 2) underwent complete ocular examinations (visual acuity, tonometry, esoftalmometry, biomicroscopy)and underwent analysis of retinal nerve fiber layer with a polarimeter GDx VCC (Zeiss). During the ocular examination a equipe of endocrinologist determineted the disease’s activity.
Results:in patients with a severe Graves orbitopathy was detected a mean reduction of retinal nerve fiber layer (Group 1). In contrast in patients with a moderate Graves orbitopathy was not individuated a significant reduction of RNFL. These results was not correlated with an intraocular pressure elevate. Besides in a group 1 patient was detected an alteration of RNFL representation during orbitopathy inflammation. This variation was reduced when was resolved this inflammation.
Conclusions:in patients with a severe Graves orbitopathy (Group 1) was observed a statistically significant RNFL reduction. This alteration was not associated with an IOP elevated. These datas showed a likely vascular cause of progressive retinal nerve fiber layer reduction. We suspected a reduction of vascular contribution in optical nerve head caused by a connective tissues increase. In patients with a moderate Graves orbitopathy (Group 2) was not observed a statistically reduction of RNFL, besides in these patients was not individuated an inflammation condition and a connective tissues increase
Oftalmologia Clinica
No full textTesto di riferimento per medici specialisti e specializzandi sulle patologie ocular
Intravitreal Bevacizumab Alone vs Laser Combined Treatment for Macular Edema Secondary to Branch Retinal Vein Occlusion
No full textNew Combined 23-20 Gauge Vitreoretinal Surgery
No full textAbstract
Purpose:to evaluate the safety and efficacy of a combined 23-20 gauge vitreoretinal surgery technique.
Methods:two groups of patients with different macular diseases were considered in this observational prospective study. All patients underwent macular surgery. In Group I transconjunctival sutureless 23 gauge vitreoretinal surgery was performed in 30 eyes. In Group II a combined 23-20 gauge vitreoretinal surgery was performed in other 30 eyes. In the combined technique of Group II two 23 gauge transconjunctival trocars for infusion cannula and endoilluminator and one 20 gauge sclerotomy for surgical instruments were carried out. 20 gauge sclerotomy was preceded by a small radial incision of the conjunctiva in the needed location and sutured at the end of surgery. Anatomical and functional parameters were evaluated before and after surgery in all 60 eyes (mean follow up 8.2 months).
Results:all surgical procedures in patients of both groups have been successfully performed. The mean first day IOP was 16,4 mmHg in Group I and 17, 2 mmHg in Group II (p>0.05). Two patients in Group I and one patient in Group II had postoperative transient hypotony. Two 23 gauge scleral ports required suture in Group I at the end of surgery, only one in Group II. No 23 gauge technique required conversion to 20 gauge surgery. A recurrent postoperative intravitreal hemorrhage in group I and one postoperative rhegmatogenous retinal detachment in Group II were observed. No endophthalmitis were noted during the postoperative follow up.
Conclusions:combined 23-20 gauge vitreoretinal surgery appears to be effective. Main indications to 23-20 gauge combined technique could be the lack of dedicated available instruments smaller than 20 gauge and some particular surgery procedures such as silicone oil management. In addition it could reduce the learning curve for small gauge vitreoretinal surgery
Evaluation of Retinal Morphology and Retinal Sensibility Before and After Macular Pucker Surgery
No full textAbstract
Purpose:To analyze the role of both morphological and functional retinal assessment to better understand macular pucker surgery outcomes.
Methods:This prospective study included 23 eyes of 23 consecutive patients affected by macular pucker who underwent standard macular surgery. Morphological examinations and functional assessments were evaluated at baseline and at month 1, 3 and 6 after surgery. Morphological examination was performed by Spectral OCT (OTI, Toronto, Canada) evaluating type and thickness of macular edema. Functional assessment included visual acuity, retinal sensibility and fixation pattern using the microperimeter (MP1, Nidek Technologies, Padova, Italy).
Results:Presurgical morphological quantitative evaluation showed mean retinal thickness of 493.50±85.87 μm; after surgery, at day 30 we found 355.50±73.28 μm, at day 90 323.70±77.40 μm, at day 180 313.17±80.75 μm. Presurgical functional evaluation showed LogMAR mean visual acuity of 0.56±0.19 and retinal sensitivity of 11.14±3.30 dB; after surgery, at day 30 we found 0.40±0.19 and 11.73±3.33 dB, at day 90 0.41±0.17 and 12.06±4.14 dB, at day 180 0.32±0.17 and 12.18±2.44 dB. Overall macular thickness reduction and visual acuity increase resulted statistically significant (p<0.05) at each control during the follow up. Mean retinal sensibility increase resulted significant (p<0.05) between baseline and day 180. Fixation pattern improved significantly (p<0.05), showing a stable fixation in 12 of 23 patients (57%) at baseline, in 17 of 23 patients (74%) at day 30 and in 20 of 23 patients (87%) at day 180, suggesting a significative recovery on visual performances.
Conclusion: Our study, as already known in literature, shows macular thickness reduction significantly related to visual acuity increase. Moreover, functional evaluation we performed underlined the role of microperimetry (retinal sensibility and fixation pattern) to complete visual acuity examination for a better definition of the efficacy of surgical treatment. Overall, our study showed that morphological retinal analysis associated to functional assessment could best evaluate clinical effectiveness of the therapy applied
Bevacizumab Versus Ranibizumab For Age Related Macular Degeneration: 1-year Outcomes Of An Interventional Study
Full text linkAbstract
Purpose:To report visual and anatomical outcomes of this interventional study comparing the efficacy of bevacizumab vs ranibizumab for the treatment of age-related macular degeneration (AMD).
Methods:56 eyes of 56 patients were involved in this interventional study between March 2009 and September 2010. Inclusion criteria were naïve choroidal neovascularization (CNV) secondary to AMD, intravitreal injection of bevacizumab 1.25mg or ranibizumab 0.5mg as monotherapy for CNV and follow up using a variable dosing regimen. Follow up visit was scheduled at month 3 and then monthly until month 12. 34 eyes were treated with bevacizumab (Group 1) and 22 with ranibizumab (Group 2). Mean age at baseline was respectively 65.4±6.2 years old and 64.3±5.6 years old. Clinical data included visual acuity (VA), central macular thickness (CMT) on Spectral Domain OCT (SDOCT) and lesion dimension from HRA2 obtained from patients records at each visit until 12 month of follow up. T Student test was performed at the end of the study to compare data.
Results:Mean BCVA ± standard deviation for Group 1 and 2 was respectively 0.33±0.23 LogMAR and 0.38±0.16 LogMAR at baseline with a change to 0.33±0.32 LogMAR (p>0.05) and 0.33±0.28 LogMAR (p>0.05) at 12 months follow up. Mean CMT at baseline was respectively 279±90μm and 340±150μm; at 12 months a significative reduction of CMT was reported on Group 1, with a mean CMT of 176±50 μm (p=0.006); on Group 2 we observed a macular thickness increase to 284±170μm (p>0.05). Mean lesion size area didn’t show a statistically significant variation in both groups at 12 months, with a mean value respectively of 7.69±6.72mm2 (p>0.05) and 10.21±10.30mm2 (p>0.05). The average number of injections was 4.21±1.1 in Group 1 and 4.86±1.5 in Group 2 (p=0.04).
Conclusions:Our study showed comparable results on both Groups at 12 months referring to VA stability: on Group 2, we observed even a significant visual acuity increase from baseline within month 3 (p=0.01). CMT evaluation at 12 months showed a recurrence of macular edema on Group 1, besides Group 2 maintained a significant decrease (p=0.006). Lesion dimension didn’t represent a significant morphological data to be compared. Our study underlined further the key role of SDOCT evaluation to better explain nowadays functional prognosis
GDxVCC Polarimetry vs a New Optical Tomograph OCT/SLO on Retinal Nerve Fiber Thickness Evaluation in Early Glaucoma
No full textEffects of Intravitreal Antiangiogenic Drugs on Ocular Blood Flow Parameters by Color Doppler Imaging
No full textAbstract
Purpose:to evaluate the effects of intravitreal antiangiogenic drugs on retrobulbar haemodynamics by color Doppler imaging (CDI) in patients with essudative age-related macular degeneration (AMD).
Methods:30 eyes of 30 patients with essudative AMD, 10 treated with Pegaptanib sodium, 10 with Ranibizumab and 10 with Bevacizumab were evaluated before and after intravitreal drug’s injection. 30 eyes of 30 healthy subjects were evaluated as control group.CDI was performed to measure peak systolic velocity, end diastolic velocity and resistive index of the ophthalmic artery, central retinal artery and posterior ciliary arteries. Maximum, minimum and mean velocities from central retinal vein and superior ophthalmic vein were also obtained by CDI.
Results:no significant differences were detected among preoperative and postoperative haemoynamics values in patients undergoing intravitreal drugs’ injections (p > 0,05). Besides, blood velocity Doppler parameters of orbital arteries and veins in patients with essudative AMD were similar to those of control group (p > 0,05).
Conclusions:this study demonstrates that intravitreal antiangiogenic drugs (Pegaptanib sodium, Ranibizumab and Bevacizumab) do not induce significant alteration on retrobulbar haemodynamics in patients with essudative AMD
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