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Biomedical subjects

E Del Piero

Publications and source records attributed to E Del Piero.

4 recordsLinked to original sources

Progressive zonal outer retinitis.

We examined an immunocompetent patient with uniocular acute progressive outer retinitis. The retinitis was curvilinear in shape, showed progressive enlargement, and appeared to be altered by treatment with intravenous acyclovir. When regressed, the affected area of retina appeared atrophic and, at one-year follow-up, demonstrated intraretinal pigment migration with retinal pigment epithelial atrophy and atrophy of the choriocapillaris. Although visual acuity was unaffected, a dense scotoma was recorded on field testing. The response to acyclovir implicates the herpesvirus family, and acyclovir or another antiherpetic agent should be considered for such cases.

Acyclovir

Anterior retinal cryotherapy in diabetic vitreous hemorrhage.

Recurrent vitreous hemorrhage associated with proliferative retinopathy can occur in eyes that do not satisfactorily respond to argon laser pantretinal photocoagulation. To evaluate the effect of relatively low-risk surgical intervention, we performed peripheral retinal cryopexy on 24 eyes of 23 diabetic patients with proliferative diabetic retinopathy and vitreous hemorrhage. In most cases, cryopexy followed complete or nearly complete panretinal photocoagulation which did not prevent subsequent vitreous hemorrhage. Existing vitreous hemorrhage cleared postoperatively in 23 of 24 eyes. The best corrected visual acuity improved in 15 eyes, remained unchanged in five, and worsened in four. Four postoperative anterior segment complications resolved completely within a short time. One patient, a 68-year-old woman who had had diabetes for 18 years, postoperatively had a macular hole in one eye and macular edema with tractional retinal detachment in the other.

Adult

Pseudomonas cepacia endophthalmitis.

A 72-year-old white man who had undergone surgical trabeculectomy and extracapsular cataract extraction with a posterior-chamber lens implantation in the left eye suffered from chronic iridocyclitis for eight months. He subsequently presented with acute hypopyon and vitritis. Anterior-chamber and vitreous cultures were positive for Pseudomonas cepacia. The infection was successfully treated with subconjunctival piperacillin, intravitreal cefotaxime, and intravenous piperacillin and gentamicin. To our knowledge, this is the first documented case of Pseudomonas cepacia endophthalmitis.

Aged

Retinal cryopexy in the management of proliferative diabetic retinopathy.

Peripheral retinal cryopexy resulted in stabilization of progressive retinopathy and vitreous hemorrhage in 13 eyes of 13 diabetics. In most cases, cryopexy followed complete or nearly complete pan-retinal photocoagulation which did not prevent subsequent vitreous hemorrhage. No eyes in our series hemorrhaged following cryopexy during the period of postoperative observation. Existing vitreous opacities generally cleared sufficiently to permit further photocoagulation. Visual acuity did not decrease on the basis of hemorrhage after cryotherapy, but rather improved in most cases. Peripheral retinal cryopexy is recommended as an alternative to vitrectomy for the initial treatment of recurrent and persistent diabetic vitreous hemorrhage.

Adult