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Biomedical subjects

A Pece

Publications and source records attributed to A Pece.

At least 19 recordsLinked to original sources
PubMed2000

Indocyanine green angiography of well-defined plaque choroidal neovascularization in age-related macular degeneration.

OBJECTIVE: To determine the natural course of well-defined plaque choroidal neovascularization (CNV) using indocyanine green angiography. METHODS: Two ophthalmologists, experts in macular diseases and indocyanine green angiography, examined 40 eyes with exudative age-related macular degeneration and a well-defined plaque CNV using complete ophthalmoscopic evaluation, fluorescein angiography, and indocyanine green angiography. The increase in the size of the plaques was analyzed using multivariate analysis, in relation to the worsening of visual acuity, with adjustment for age, sex, and length of follow-up. RESULTS: Mean follow-up was 13.5 months (median, 11 months). Initial and final mean visual acuity were 20/46 (median, 20/50) and 20/65 (median, 20/100), respectively. The mean initial size of the plaque was 6.62 mm2 (median, 6.20 mm2), and the mean final size was 10.40 mm2 (median, 9.76 mm2). The enlargement was statistically significant (P<.001). CONCLUSIONS: We found that plaque CNV tends to become larger with time, the enlargement reaching about 40% in 1 year of follow-up. The resulting loss of visual acuity, however, is not significant, and is slightly correlated with the extension of the lesion; it also does not appear to be directly related to sex.

Aged↗
PubMed2000

Chorioretinal involvement in primary systemic nonfamilial amyloidosis.

PURPOSE: To report a case of primary systemic nonfamilial amyloidosis studied by fluorescein angiography and indocyanine green angiography. METHODS: Case report. A 59-year-old woman with primary systemic nonfamilial amyloidosis presented bilateral diffuse deep hemorrhages and pigmentary mottling at the posterior pole. RESULTS: On fluorescein angiography bilateral diffuse areas of hypofluorescence were present. Indocyanine green angiography showed large hypofluorescent areas with hypofluorescent lines in the midperiphery and hyperfluorescent streaks in the peripapillary area. CONCLUSIONS: In this case of primary systemic nonfamilial amyloidosis, diffuse bilateral chorioretinal abnormalities included hemorrhages and pigmentary mottling at the posterior pole, with hypofluorescent areas on fluorescein angiography and indocyanine green angiography, as well as hypofluorescent lines in the midperiphery.

Amyloidosis↗
PubMed2000

ICGA-guided laser photocoagulation of occult choroidal neovascularization in age-related macular degeneration. Indocyanine green angiography.

PURPOSE: To evaluate the efficacy of indocyanine green angiography (ICGA)-guided laser photocoagulation in eyes with fluorescein angiographic evidence of occult choroidal neovascularization (O-CNV) in patients with age-related macular degeneration (ARMD) with or without pigment epithelium detachment (PED). METHODS: Eighty eyes of 79 consecutive patients with O-CNV underwent laser treatment of a clearly outlined extrafoveal ICGA hyperfluorescent area, presumed to be focal CNV. Four types of presumed CNV were treated: Group 1 (20 eyes), CNV beneath the PED; Group 2 (23 eyes), CNV at the margin of the PED; Group 3 (10 eyes), parapapillary CNV and PED; and Group 4 (27 eyes), macular CNV without PED. Median follow-up was 17.5 months (range, 6-24 months). RESULTS: After 1 year, 15% of the eyes in Group 1, 30% in Group 2, 100% in Group 3, and 52% in Group 4 had obliteration of the presumed CNV. After 1 year, visual acuity was stable or improved in 18% of Group 1, in 37.5% of Group 2, in 100% of Group 3, and in 73% of Group 4. The remaining eyes worsened. CONCLUSIONS: Indocyanine green angiography-guided laser treatment may improve or stabilize visual acuity in some eyes with O-CNV. The best outcome is seen in eyes with presumed parapapillary CNV, probably made up of choroidal telangiectases in many cases. The type and location of the presumed CNV influence prognosis after laser treatment considerably. A randomized, controlled clinical study appears necessary to investigate the efficacy of ICGA-guided laser treatment in different types of presumed CNV. The inclusion criteria for further trials need to be defined with precision, as data from patients with different choroidal vascular abnormalities have been pooled until now.

Aged↗
PubMed2000

Real-time quantification of the proliferative state in astrocytomas.

OBJECTIVE: To evaluate proliferative activity in a set of gliomas and to compare the quantitative data obtained by a real-time processor with the labelling index (LI) and mitotic index (MI). STUDY DESIGN: Ki-67 immunostaining was performed on paraffin-embedded specimens from 42 cases of glioblastomas, 17 cases of anaplastic astrocytomas and 14 cases of low grade astrocytomas. Nuclear positivity was calculated as LI and by a real-time image processor for quantitative evaluation. MI was also calculated at 10 high-power fields. The data obtained from glioblastomas were compared with those from anaplastic and low grade astrocytomas. To all the data was applied the Pearson test to verify the correlation between counting and quantitative values and between proliferative markers and survival. RESULTS: A positive trend from low grade astrocytomas to glioblastomas was found for Ki-67 (LI and quantitative values) and MI, with highly significant differences between the three grades of gliomas considered. A good correlation between LI and quantitative values of Ki-67 was found. Very little relationship resulted between survival and Ki-67 LI. No relationship was found between survival and quantitative values of Ki-67. CONCLUSION: Ki-67 allowed effective separation of astrocytic tumors with different grades of malignancy. Quantitative evaluation of color information by means of a real-time processor proved to be a useful, objective and fast way to obtain readings, useful for grading purposes but not for prognostic evaluation.

Astrocytoma↗
PubMed1998

Indocyanine green angiography in enlarged blind spot syndrome.

PURPOSE: To report the indocyanine green angiography findings in a case of acute idiopathic blind spot enlargement syndrome. METHOD: The patient underwent ophthalmologic examination with fluorescein angiography and indocyanine green angiography. RESULTS: A monocular enlarged blind spot was found on automated perimetry; fluorescein angiography showed a hypofluorescent peripapillary atrophic area and indocyanine green angiography highlighted diffuse, small hypofluorescent spots scattered throughout the posterior pole. Visual field defects and indocyanine green angiography abnormalities resolved over 4 weeks. CONCLUSION: Indocyanine green angiography in acute idiopathic blind spot enlargement syndrome showed many lesions not visible with fluorescein angiography, indicating a choroidal involvement reaching not only the peripapillary area but the entire posterior pole.

Acute Disease↗
PubMed1998

Indocyanine green angiography in age-related macular degeneration with occult neovascularization.

This study has been conducted to assess the sensitivity of indocyanine green angiography (ICGA) in detecting choroidal neovascularization (CNV) in patients with age-related macular degeneration (ARMD) with occult CNV at fluorescein angiography (FA) and to establish their eligibility for laser photocoagulation. Three hundred eighty-three eyes of 355 consecutive patients with occult CNV at FA were studied by ICGA; occult CNV with or without pigment epithelial detachment (PED) were detected as well. Eligibility for laser treatment was established on the basis of the ICGA-guided CNV extension and localization. Out of 157 eyes (41%) with occult CNV and PED, 74 (47.1%) showed focal ICGA CNV, 35 eyes (22.3%) had plaque CNV. Thirty-five eyes with PED (22.3%) appeared serous without CNV, and in 13 eyes (8.3%) no CNV was detectable because of large hemorrhages. Out of the 226 eyes (59%) presenting occult CNV without PED, 94 eyes (41.6%) had plaque CNV, and 58 (25.7%) had focal CNV. In 74 eyes (32.7%), there was no detectable CNV or only an ill-defined ICGA appearance. ARMD with PED is closely associated with focal CNV, while plaque CNV is largely found in exudative ARMD without PED (p < 0.001). Considering all the cases examined by ICGA, CNV was evident in 261 eyes (68%) occult at FA. Extrafoveal CNV laser treatment was recommended for 103 eyes (27%). Our results suggest that ICGA may be useful in the diagnosis and management of ARMD with occult CNV at FA increasing the number of patients eligible for laser treatment.

Aged↗
PubMed1997

Laser photocoagulation of choroidal neovascularization in angioid streaks.

PURPOSE: To determine if laser photocoagulation of macular choroidal neovascularization in angioid streaks may be effective in preventing severe loss of vision. METHODS: Sixty-six consecutive eyes of 52 patients with extrafoveal, well-defined choroidal neovascularization secondary to angioid streaks who underwent direct laser photocoagulation were followed for 3-108 months (mean, 34.5 months; median, 20 months). RESULTS: Pretreatment mean visual acuity was 20/40 (range, 20/200-20/20), postlaser outcome was a visual acuity of 20/50 at 3 months, 20/50 at 6 months, 20/80 at 1 year, 20/80 at 2 years, 20/100 at 3 years, 20/125 at 4 years, 20/125 at 5 years, 20/100 at 6 years, and 20/80 at 7 years. During the first year after treatment there was a significant decrease in visual acuity (P < 0.01), but no significant change thereafter. Choroidal neovascularization recurred one or more times in 77% of the eyes, but by the final examination choroidal neovascularization had been eliminated completely in 31 eyes (47%). Fellow eyes with naturally progressed choroidal neovascularization were considered control eyes. Final visual acuity in treated eyes was definitely better than that in untreated eyes (P < 0.01). CONCLUSIONS: This is the largest series of eyes treated by laser photocoagulation for angioid streaks and choroidal neovascularization ever reported. Laser photocoagulation of choroidal neovascularization in angioid streaks may end the choroidal neovascularization and help stabilize visual acuity or slow down visual loss. Considering the very high frequency of recurrences (77% of the eyes studied), an intense clinical and fluorangiographic follow-up period is strongly recommended, mainly for the first 3 months after treatment.

Adult↗
PubMed1997

Indocyanine green angiography in angioid streaks.

PURPOSE: To define the indocyanine green angiographic aspects of angioid streaks, peau d'orange and choroidal new vessels. METHODS: Fifty-seven consecutive patients (112 eyes) with angioid streaks were evaluated by fluorescein angiography and indocyanine green angiography. RESULTS: Indocyanine green angiography showed angioid streaks in all eyes. We identified three different indocyanine green patterns of streaks (four groups): fluorescent (63%), hypofluorescent (8%), 'track-like' (19%) and mixed (10%). Angioid streaks were visualized better by indocyanine green angiography and red-free retinography than fluorescein angiography. Peau d'orange was seen better and found to be more widespread by indocyanine green angiography. Fluorescein angiography visualized choroidal neovascularization better, except for occult forms. CONCLUSIONS: Our findings show that angioid streaks have different indocyanine green angiography patterns. Considering that the hypofluorescent pattern was significantly observed in younger patients, indocyanine green angiography aspects might be correlated with different stages of the disease.

Adult↗
PubMed1997

[Fetal uropathies: anatomo-pathologic background].

The kidney malformations are complex anatomo-clinical entities that can be described with different classification approaches, based on morphological or etiopathogenetic criteria. The most serious fetal uropathies can be associated with the oligohydramnios sequence, due to insufficient urine escretion, related, for example to bilateral renal agenesis. A second malformation sequence can also be present, the so-called prune belly syndrome, in which an early urethral obstruction can produce abnormal bladder distension and finally renal dysplasia and globous dilation of the abdomen. The anatomo-pathological experience of the last ten years in the Institute of Pathological Anatomy of the University of Bari is based upon 154 cases of congenital uropathies in second trimester fetuses. Almost 80% of these cases presented also other associated anomalies, both chromosomal and non chromosomal syndromic or in casual combination. The possible echographic recognition of these pathologies, together with genetic and anatomopathological studies allow to categorize the fetal uropathies in two groups: the first characterized by an early or late obstruction of the urinary tract, in "sensu strictu" the true obstructive uropathies, and the second, formed by different morphologies all genetically determined.

Female↗
PubMed1996

Indocyanine green and fluorescein angiography of surgically excised macular choroidal neovascularizations: correlations with histopathologic and ultrastructural findings.

BACKGROUND: Informations are expected from the histopathological study of surgically excised choroidal neovascular membranes (CNMs), particularly in relation to the angiographic aspects of vascular architecture. METHODS: Fluorescein and indocyanine green (ICG) angiograms were studied together with the histopathological features of 12 surgically excised subfoveal CNMs in eyes affected by age-related macular degeneration (ARMD). RESULTS: Instead of the early and delayed diffuse hyperfluorescence secondary to CNMs observed on fluorescein angiography (seven were well defined, five scar evolved), ICG revealed (a) very early hypofluorescence of the membrane bulk over the fluorescence of the outer choroidal vascular bed and (b) late hyperfluorescence gradually increasing and partially defining the border of membranes. CNMs with well-defined hyperfluorescent aspects were characterized by fibrovascular bulk lined on one side by retinal pigment epithelium. Fibrosis reaction predominated over the vascular components in scar-evolved membranes. CONCLUSIONS: Fluorescein and ICG angiographic differences in the appearance of CNMs could depend on (a) the morphological structure and size of the CNM (b) its location within the chorioretinal layers and (c) different molecular characteristics of the dyes used.

Aged↗
PubMed1994

Electroretinographic findings in congenital oculomotor apraxia (Cogan's syndrome).

We performed visual evoked potential testing and electroretinography in five patients with Cogan's oculomotor apraxia. The visual evoked potentials were normal, confirming previously reported data. Electroretinograms were abnormal in two of the five patients examined. A previous study showed normal electroretinogram responses bilaterally in one patient. Our findings suggest the existence of two variants of the syndrome; the one with electroretinogram anomalies has a worse visual prognosis.

Apraxias↗
PubMed1994

Echographic diagnosis of Drusen of the optic nerve head in patients with angioid streaks.

A total of 58 patients (116 eyes) with angioid streaks, referred to this department over 2 years (1990-1992), underwent a thorough ophthalmic examination, retinal fluorescein angiography, dermatological visit with skin biopsy, and a series of other examinations (blood and biochemistry, skull X-ray, vascular echo Doppler, abdominal ultrasound) and eye ultrasonography. Fifty patients (100 eyes, 86.2%) had pseudoxanthoma elasticum (PXE). In the whole caselist, 21.6% had drusen compared with 21.0% in the group with PXE. Both these findings are higher than those published elsewhere. Drusen of the optic nerve head were also found in 25% of the 16 eyes (8 patients) with angioid streaks but no PXE. We believe we found a higher prevalence of drusen of the optic nerve head in these patients with angioid streaks because we systematically employed ultrasound.

Adult↗
PubMed1992

Best's multiple vitelliform degeneration.

Best's disease with multifocal lesions is rare. The authors describe four cases of multifocal vitelliform disease. The fluorescein angiographic features of macular and extramacular lesions are considered. Different stages of evolution may be present between central and extramacular lesions.

Adolescent↗
PubMed1992

[Juvenile serous macular detachment of the pigmented epithelium].

Juvenile macular detachment of the retinal pigmented epithelium is rarely seen clinically. Single or multiple detachments can occur and are due to the accumulation of liquid in the subretinal space. The natural history of the disease, which usually affects young people, has not yet been defined. We examined and followed 19 eyes of 15 patients affected by macular juvenile serous detachment of the retinal pigment epithelium, not associated with other retinal disturbances. The patients were followed for a mean period of 12 months (range 6-33 months). The mean age was 48 years (range 40-59 years): 7 patients were male and 8 female. Mean initial visual acuity was 8/10 (range 1/10-10/10) and mean final visual acuity was 9.2/10 (range 6/10-10/10). Detachment of the retinal pigmented epithelium was unchanged in 58% of cases, decreased or disappeared in 37% of cases and increased in 5% of cases. These results indicate that the natural course is usually good and photocoagulation is not necessary.

Adult↗