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Biomedical subjects

E Balestrazzi

Publications and source records attributed to E Balestrazzi.

At least 19 recordsLinked to original sources

Histological findings of a surgically excised myopic choroidal neovascular membrane after photodynamic therapy. A case report.

BACKGROUND: The authors describe a myopic choroidal neovascular membrane excised 4 months after photodynamic therapy (PDT). METHODS: A 68-year-old woman with classic choroidal neovascularization (CNV) due to pathologic myopia underwent PDT with verteporfin in the left eye. Four months after treatment a full-thickness macular hole was diagnosed in the same eye and the patient underwent vitrectomy with submacular membranectomy. The subfoveal membrane was studied by light microscopy and immunohistochemical techniques. RESULTS: Light microscopy showed a thin fibrovascular membrane covered by residual retinal pigment epithelium. The membrane contained homogeneous matrix with small collagen bundles, fibroblasts and small blood vessels. The distribution of blood vessels was nonuniform: extravasated red blood cells, macrophages and other inflammatory elements were not present in the fibrous matrix. Endothelial cells were highlighted by CD34 immunostaining and did not show any significant alteration. There was no evidence of inflammatory cells or thrombosis inside vascular lumina. CONCLUSIONS: Histologic examination of the neovascular membrane showed features similar to those of surgically excised myopic CNV without PDT treatment. Our findings suggest that PDT-induced occlusion is temporary. Fluorescein leakage from CNV after a single PDT treatment can be considered as an sign of blood vessel regrowth or recanalization indicating that multiple treatments are necessary.

Aged↗

Treatment of vascular retinopathies with Pycnogenol.

The aim of our study was to investigate the effects of Pycnogenol on the progression of diabetic retinopathy and other vascular retinal disorders. The study consisted of a double-blind phase in which 20 patients were recruited and randomly treated with placebo or Pycnogenol (50 mg x 3/day for 2 months) and an open phase in which another 20 patients were treated with Pycnogenol at the same dose schedule. In total, 40 patients with diabetes, atherosclerosis and other vascular diseases involving the retina were enrolled; 30 of them were treated with Pycnogenol and 10 with placebo. The results demonstrated a beneficial effect of Pycnogenol on the progression of retinopathy. Without any treatment (placebo) the retinopathy progressively worsened during the trial and the visual acuity significantly decreased; on the contrary, the Pycnogenol-treated patients showed no deterioration of retinal function and a significant recovery of visual acuity was also obtained. The fluorangiography showed an improvement of retinal vascularization and a reduced endothelial permeability and leakage in the Pycnogenol, but not in the placebo-treated, patients. The ophthalmoscopy and the electroretinogram (ERG) also confirmed the beneficial effects of Pycnogenol. The mechanism of action of Pycnogenol may be related to its free radical (FR) scavenging, anti-inflammatory and capillary protective activities. It has been suggested that Pycnogenol may bind to the blood vessel wall proteins and mucopolysaccharides and produce a capillary 'sealing' effect, leading to a reduced capillary permeability and oedema formation.

Diabetic Retinopathy↗

Local chemotherapy with interferon-alpha for conjunctival mucosa-associated lymphoid tissue lymphoma: a preliminary report.

OBJECTIVE: To evaluate the efficacy of subconjunctival interferon-alpha for the treatment of conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma. DESIGN: Small, noncomparative, interventional case series. PARTICIPANTS: Five patients with histologically proven conjunctival MALT lymphoma were studied prospectively. METHODS: Patients were given 1,500,000 international units (IU) of interferon-alpha (IFN-alpha) (Roferon-A) subconjunctivally inside the lesion, three times a week for four weeks. If there was even a minimal response, a further cycle of 1,000,000 IU three times a week for four weeks was administered. Patients received a maintenance dose of 1 million IU, every 15 days for 4 times, after clinical resolution of the lesion. MAIN OUTCOME MEASURES: Patients were followed clinically, with slit lamp examination, for evidence of tumor disappearance or recurrence. RESULTS: Complete response was obtained in all patients. The lesion resolved completely by the eighth week. Four patients did not show any local recurrence with a median follow-up of 21 months (12-36 months). One patient presented with a recurrence after 11 months, in association with systemic lymphoma progression. CONCLUSIONS: Local chemotherapy with IFN-alpha seems to be an effective treatment modality, alternative to radiotherapy, for conjunctival MALT lymphomas.

Adult↗

3p13 region: a possible location of a tumor suppressor gene involved in uveal melanoma.

To contribute to a better understanding of the role of chromosomal rearrangements in the tumorigenesis of uveal melanoma, we present a case in which a structural aberration of chromosome 3 could indicate the specific region in which an uveal melanoma tumor suppressor gene could be located. We obtained a primary cell culture, characterized by cytogenetic study, through GTG- and CBG-banding techniques by using a mechanical dissection of a tumor sample obtained from an uveal melanoma. Cytogenetic analysis performed in the primary cell culture highlighted the presence of a structural rearrangement involving chromosomes 3 and 22. A t(3;22)(p13;p11) was observed as the only present clonal aberration. The 3p13 breakpoint involved in the aberration observed in our case could be essential in restricting the candidate region for the locus of an uveal melanoma tumor suppressor gene located on chromosome 3.

Choroid Neoplasms↗

Videokeratographic changes after laser in situ keratomileusis to correct high myopia.

PURPOSE: To evaluate the videokeratographic changes and patterns after laser in situ keratomileusis (LASIK) in high myopia using computerized videokeratography. SETTING: San Salvatore Hospital, Chair of Ophthalmology, University of L'Aquila, L'Aquila, Italy. METHODS: Forty-one eyes of 26 patients treated with no-suture nasal-hinged flap LASIK for an attempted mean spherical equivalent correction of -13.9 diopters (D) +/- 4.1 (SD) (range -8.0 to -22.0 D) were evaluated. Mean patient age was 35.2 +/- 9.8 years. Mean follow-up was 15.1 +/- 6.7 months (range 6 to 26 months). RESULTS: Thirty-five eyes (85.4%) were within +/- 2.0 D of the planned correction, with a refractive error greater than 3.0 D in the 7.3% of eyes. Mean central corneal power decreased from 43.2 +/- 1.8 D (range 38.70 to 47.40 D) to 35.8 +/- 3.8 D (range 30.3 to 42.6 D). Mean preoperative corneal astigmatism decreased from 1.2 +/- 0.9 D (range 0.2 to 4.2 D) to 0.9 +/- 0.9 D (range 0.2 to 3.3 D). Videokeratographic qualitative analysis showed corneal shape changes within 15 days after surgery. Corneal patterns then stabilized, and 37 eyes (90.3%) had no significant modifications in corneal refractive power after 1 month. CONCLUSION: After LASIK in highly myopic eyes, videokeratographic maps showed corneal power stabilized within 1 month in most eyes and there was no irregular astigmatism if the treatment was well centered.

Adult↗

Natural history of macular subretinal hemorrhage in age-related macular degeneration.

PURPOSE: To define the natural course of extensive submacular hemorrhage in age-related macular degeneration (AMD). PATIENTS AND METHODS: The clinical charts of 54 patients (60 eyes) older than 55 years with subretinal hemorrhage larger than 1 disk diameter and extending beneath the fovea were retrospectively reviewed. The age of the patient, the use of antihypertensive or anticoagulant medication, visual acuity, biomicroscopic and fluorescein and indocyanine green (in 33 cases) angiographic data were recorded at presentation and during follow-up. RESULTS: At the initial examination, average visual acuity was 20/240 (range from 20/70 to light perception). During follow-up (mean 24 months) visual acuity worsened in 80% of the eyes with a mean final visual acuity of 20/1, 250 (range from 20/100 to light perception). The initial size and thickness of hemorrhage were correlated with initial and final visual acuity. Recurrence of hemorrhage resulted in an important impact on final visual acuity. Anatomic outcome showed fibrous tissue proliferation in 23 eyes (38.3%), atrophic scar in 15 eyes (25%) and occurrence of a retinal pigment epithelium tear in 13 eyes (21.6%). CONCLUSION: The visual outcome in eyes with submacular hemorrhages due to AMD is very poor. Size and thickness of the hemorrhage influenced negatively the natural prognosis. A surgical approach can be considered although it has not yet a widespread use.

Aged↗

Antioxidant pattern in uveal melanocytes and melanoma cell cultures.

PURPOSE: To investigate the antioxidant status of cultured uveal melanocytes from patients with uveal melanoma and uveal melanoma cells to characterize some of the biochemical properties of these cells in respect to the normal cutaneous melanocytes. METHODS: The fatty acid pattern of membrane phospholipids, intracellular vitamin E level, and superoxide dismutase (SOD) and catalase activities were studied in uveal melanocytes (n = 10) and uveal melanoma cell (n = 10) cultures, by gas chromatography mass spectrometry or by spectrophotometer. RESULTS: Among the uveal melanocyte cultures, two groups were differentiated, according to catalase activity: group A with catalase values comparable to those of cutaneous ones and higher SOD activity and group B with catalase values 2 SD lower (P<0.001) and lower SOD activity. Vitamin E concentration was not significantly different between melanoma cells and melanocytes, whereas a significantly higher percentage of polyunsaturated fatty acids was found in melanoma cells and the B group of melanocytes (P = 0.022). In uveal melanoma cells SOD activity was significantly lower than that detected in uveal melanocytes (P< 0.005). CONCLUSIONS: These results show a different pattern of antioxidants in uveal melanocytes with respect to cutaneous ones, possibly related to the anatomic distribution. However, as in cutaneous melanocytes, two subgroups were identified on the basis of the antioxidant pattern that could be the expression of a constitutional increased susceptibility to oxidative stress in some subjects. Moreover, an imbalance of the antioxidants was observed in melanoma cells, possibly related to the disease status and progression.

Adult↗

The use of ultrasound biomicroscopy in pre-operative evaluation of orbital-blepharal neoformations: report of a case.

In our study we have taken into consideration the use of ultrasound biomicroscopy (UBM) in a case of orbital-blepharal lymphoma. The advantages of this methodology, which is considered a refinement of B scan ultrasonography, compared with other instruments at present available on the market, have been described. We have tried to show how the instrument for biomicroscopic ultrasonography makes it possible to obtain images of the anterior segment of the eye in every detail; it is, therefore, capable of giving us information once only available by means of examining histopathological sections. Apart from the advantages, in this work we have also described the limits of this methodology, which in order to allow an accurate diagnosis must always be accompanied by the traditional ocular echography.

Adult↗

Biometric pre-operative evaluation of ocular axial length in patients subjected to corneal transplantation.

In cases of keratoconus and consequent penetrating keratoplasty, the refractive requirements of the patient determine the dimensions of the donor button and the receiving wound size. The pre-operative biometric evaluation of the axial parameters may induce the surgeon to choose an oversized button to obtain the right curvature of the cornea and avoid hypermetropia. In this study we present 20 patients transplanted between 1993 and 1995, 13 female, 7 male, aged between 23 and 45 years. These cases demonstrate the utility of this easy and economic technique.

Adult↗

Echographic follow-up in patients who have undergone sclero-uveotumorectomy.

A-B scan echography provides accurate information on the location, the nature, the extension of a neoplasm and the involvement of neighbouring tissues as well as on the postsurgical evolution. In this study, we intend to give accurate and useful indications to the surgeon concerning conservative surgery and the follow-up after sclero-uveotumorectomy in cases of uveal neoformations. Between January 1988 and June 1996, we examined 46 patients by means of echography before and after sclero-uveotumorectomy.

Decision Making↗

Evaluation of the echographic contribution to the parasurgical treatment of melanomas of small dimensions.

In this work we underlined the contribution of echography in the parasurgical treatment (photocoagulative) of melanomas of small dimensions. Fourteen patients were examined; some of them were treated with argon laser, others with krypton laser. The echographic examination was performed with the A-B scan technique, naturally accompanied by fluorangiography before and after the operation. An accurate echographic and fluorangiographic follow-up makes it posible to control the evolution of the lesions efficaciously. From this work it is clear how echography gives highly reliable results which allow us, therefore, both to make an adequate therapeutic decision and to evaluate the efficaciousness of the treatment itself.

Adult↗

Neoplasia-like echographic evidence in retinopathies of several aetiologies: a case report.

In ocular retinal pathology, several aetiological entities showing various clinical and ophthalmoscopic pictures can simulate a tumour. The contribution of echography to the diagnostic research in ophthalmology is really important and the good knowledge of the difficulties and echographic limits is essential. We specifically report a tubercular granuloma clinically and echographically simulating a ciliary-body melanoma.

Ciliary Body↗

Alterations of the internal reflectivity of extra-ocular muscles associated with several clinical stages of Graves' ophthalmopathy.

In the period between February 1992 and June 1996, the authors performed extra-ocular muscle echobiometry on 163 patients with Graves' disease. The aim of this study is the evaluation of changes occurring in several clinical stages. The authors noted an increase in internal muscular reflectivity in the advanced phases and an irregular structure in the early stages. Controversial results in the literature warrant mastery of the method and further research.

Adult↗

Long-term results of excimer laser photorefractive keratectomy in high myopia: a preliminary report.

BACKGROUND AND OBJECTIVE: To evaluate the results of 193-nm excimer laser photorefractive keratectomy (PRK) performed on highly myopic eyes with a follow-up of at least 2 years. PATIENTS AND METHODS: Fifty-three eyes of 41 patients were treated with a myopic PRK for an attempted correction ranging between -8 and -17 D (mean -10.9 +/- 2.8 SD). RESULTS: The follow-up ranged from 24 to 60 months (mean 34.1 months +/- 10 SD). Fifty-three percent of the eyes achieved a refraction within +/- 2 D of the planned correction, with a refractive error greater than 4 D in 21% of the treated eyes. The uncorrected visual acuity was 20/40 or better in 45% of the eyes. There were no significant opacities in 85% of the eyes examined. A second treatment was performed on 5 eyes. CONCLUSION: The results suggest that excimer laser PRK is a safe and relatively effective alternative for treating highly myopic eyes, and its effects are stable over a long period of time.

Adult↗