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Biomedical subjects

F Bandello

Publications and source records attributed to F Bandello.

At least 19 recordsLinked to original sources
PubMed2001

Familial primary pulmonary hypertension and associated ocular findings.

BACKGROUND: Familial primary pulmonary hypertension (PPH) is a rare, fatal, autosomal dominant disease that results in right heart failure from idiopathic obliteration of the pulmonary arteries. Patients develop stagnation of venous blood flow and elevated venous pressure. METHODS: The authors retrospectively reviewed the clinical records of three patients diagnosed with PPH that was confirmed on the basis of physical examination, chest X-ray, electrocardiogram, and echocardiogram. Cardiac catheterization excluded cardiac shunt and other secondary causes of pulmonary hypertension. RESULTS: Two patients presented with a clinical picture resembling venous stasis retinopathy, and one with bilateral choroidal detachments. Two patients had delayed choroidal filling on fluorescein angiography, which was confirmed in one patient with indocyanine green videoangiography. CONCLUSIONS: Elevated venous pressure found in PPH is responsible for the delayed choroidal perfusion and the reduced venous blood outflow. This explains the clinical findings of venous stasis retinopathy and choroidal detachments seen in these patients.

Adult↗
PubMed2001

[ICG angiography and retinal pigment epithelial decompensation (CRSC and epitheliopathy)].

PURPOSE: To evaluate the prognosis of chronic central serous chorioretinopathy (CSC) and to assess whether certain clinical and angiographic features are associated with increased risk of vision loss. METHODS: All of the 51 patients with chronic CSC, who had received a baseline evaluation with fluorescein angiography (FA) and indocyanine green angiography (ICGA), during the last 5 years were retrospectively included in the study. RESULTS: The mean age was 49 years (range: 28-77 years). Sixteen out of 102 eyes (15.7%) of 14 patients lost at least 3 lines (0.3logMAR) after a mean follow-up of 34.7 months (range: 12-72 months). Logistic regression showed that CSC onset more than 7 years before inclusion (odds ratio: 4.3, p=0.024) and having areas of confluent RPE atrophy with FA at baseline (at least 2 disc diameters, odds ratio: 4.9,p=0.020) were independently associated with vision loss. Choroidal neovascularization was observed during follow-up in 4 eyes of 3 patients. CONCLUSION: Disease duration of more than 7 years and the presence of confluent RPE atrophy independently characterized CSC patients at higher risk for visual loss in our series.

Adult↗
PubMed2000

Bilateral juxtafoveolar telangiectasis in monozygotic twins.

PURPOSE: To report the clinical and angiographic features of two monozygotic twins affected by bilateral group 2 idiopathic juxtafoveolar telangiectasis. METHOD: Case reports. RESULTS: Two 64-year-old women, who were identical twins, were suffering from visual loss. One twin had suffered from visual loss for 1 year and had a visual acuity of 20/25 in both eyes, and the other twin had suffered for 2 years and had a visual acuity of 20/30 in both eyes. Fluorescein angiography disclosed similar fundus features. An analogous area of capillary telangiectasis and leakage was observed in the right macula, where no intraretinal pigment was seen; the left macula showed a similar amount of intraretinal pigment associated with tiny right-angle venules and minimal leakage. CONCLUSION: This observation raises the issue of genetic influences in the pathogenesis of this disease.

Diseases in Twins↗
PubMed2000

Perilimbal topical anesthesia for clear corneal phacoemulsification.

PURPOSE: To evaluate the efficacy of perilimbal topical anesthesia for clear corneal cataract surgery. SETTING: Department of Ophthalmology, University of Udine, Udine, Italy. METHODS: Seventy-five consecutive patients were studied for perioperative pain, visual outcome, and intraoperative complications. Topical anesthesia was administered with a cellulose sponge soaked in preservative-free lidocaine 2%. The perilimbal area was touched 360 degrees for 30 seconds with the sponge tip under the operating microscope just before surgery. No sedation or adjunctive anesthetic drops were given. Surgery was performed through a temporal corneal tunnel with the easy-chop technique. Pain was scored on a subjective scale from 0 (no pain) to 3 (severe pain). Visual acuity was measured 1 day and 1 week after surgery. Mean operating time was recorded. RESULTS: Sixty-nine patients (92%) tolerated the procedure well, giving a pain score of 0 or 1. Six (8%) of the 40 patients who had a single stitch at the end of surgery scored 2. No patient reported pain during iris touch, intraocular lens implantation, or conjunctiva manipulation. No intraoperative complications were recorded. Mean operating time was 12.7 minutes +/- 3.7 (SD) (range 7 to 34 minutes). Mean preoperative visual acuity was 0.4 +/- 0.2 (range 0.01 to 0.80). Visual acuity of 0.5 or better was attained in 93.6% of eyes 1 day and in 96% 1 week postoperatively. CONCLUSIONS: Perilimbal topical anesthesia was an effective and easy-to-administer anesthetic procedure for phacoemulsification, providing good perioperative pain tolerance by patients and rapid visual recovery.

Adult↗
PubMed1999

When and how to do a grid laser for diabetic macular edema.

Macular edema is a common feature of posterior segment diseases. It is an expression of abnormal permeability in either retinal vessels (inner blood-retinal barrier) or in the retinal pigment epithelium (outer blood-retinal barrier). It occurs in either a diffuse pattern where the macula appears generally thickened or, in more severe cases, as cystoid edema with the typical petaloid appearance. Grid laser treatment may be useful to reduce macular edema. Spots of 100-250 micrometers in diameter are applied to the whole posterior pole, one to two groups apart. The foveal avascular zone remains untouched. In patients treated bilaterally, areas temporal and nasal to the macula must be spared to prevent the development of deep scotomas. The mechanism yielding positive results with the grid technique is still debated. Among the most reliable hypotheses are: Proliferation of pigment epithelial cells, followed by and improved efficiency of the outer blood-retinal barrier; proliferation of endothelial cells in retinal capillaries followed by an improved efficiency of the inner blood-retinal barrier; improvement of the retinochoroidal exchanges, and finally, release by coagulative necrosis of a factor able to improve the efficiency of the blood-retinal barriers. Lasers with long wavelengths, such as krypton red and diode, are the most appropriate ones to perform grid treatment.

Blood-Retinal Barrier↗
PubMed1998

Axial length and refraction in retinal vein occlusions.

To assess whether axial length and refraction are risk factors for retinal vein occlusion, we measured these parameters in 88 consecutive patients with unilateral branch retinal vein occlusion (BRVO), in 58 consecutive patients with unilateral central retinal vein occlusion (CRVO) and in 50 patients selected as a control group. Patients and controls were free or affected by systemic or local predisposing factors. We compared eyes with CRVO with control eyes, eyes with BRVO with control eyes, and eyes with CRVO with eyes with BRVO. Comparing CRVO eyes and controls, none of the investigated variables was shown to be significant. From the analysis of BRVO eyes versus controls, it resulted that refraction was the only variable which played the role of an independent prognostic factor. When comparing BRVO eyes with CRVO eyes, we found that age was slightly related to the development of BRVO. In conclusion, faulty refraction appeared to be a risk factor for the development of BRVO. We did not find any influence of axial length on the occlusion of retinal veins.

Adult↗
PubMed1997

Congenital aphakia in Peters' anomaly syndrome. A case report.

The authors report a case of congenital bilateral corneal opacities in which one of the eyes was enucleated because of malignant glaucoma and corneal perforation. Corneal defects and iridocorneal adhesion were found, but aphakia was the major pathologic ocular finding. The clinical picture and pathology study indicated this case as a Peters' anomaly presenting congenital aphakia.

Anterior Eye Segment↗
PubMed1996

Double-frequency Nd:YAG laser vs. argon-green laser in the treatment of proliferative diabetic retinopathy: randomized study with long-term follow-up.

BACKGROUND AND OBJECTIVE: A randomized clinical trial using the argon-green (514 nm) and the double-frequency Nd:YAG (532 nm) lasers was carried out on 42 eyes with proliferative diabetic retinopathy (PDR), with the aim of assessing the long-term effects of double-frequency Nd:YAG panretinal photocoagulation (PRP). MATERIALS AND METHODS: Twenty-one eyes were randomized to argon laser treatment (ALT) and 21 to double-frequency Nd:YAG laser treatment (NdLT). The mean follow-up was 28.90 months (+/- 6.13) in the ALT group and 29.57 months (+/- 5.17) in the NdLT group. RESULTS: In the ALT group, 20 eyes (95.2%) showed regression of PDR and one eye (4.8%) enlargement of pre-existing new vessels. In the NdLT group, neovascularization regressed in 20 eyes (95.2%) and increased in one (4.8%). CONCLUSIONS: The long-term efficacy of double-frequency Nd: YAG laser PRP in the treatment of PDR thus appears to be similar to that of argon-green.

Adult↗
PubMed1996

Vitreous laser absorption following fluorescein angiography in diabetic patients.

BACKGROUND: Sodium fluorescein staining of the vitreous following fluorescein angiography may interact with laser photocoagulation. METHODS: We evaluated the laser absorption by fluorescein in the vitreous when photocoagulation is performed following fluorescein angiography in 15 eyes of nine diabetic patients. Axial fluorescein concentration in the vitreous was measured by a scanning vitreal fluorophotometer. The amount of light absorbed by the fluorescein within the vitreous was calculated according to the Lambert-Beer law. RESULTS: The mean fluorescein concentration ranged from 2.93 ng cm-3 to 105.16 ng cm-3 at 1 h after injection of fluorescein and from 8.03 to 188.56 ng cm-3 after 4 h. Maximum laser absorption at 488 nm ranged from 6.79% (after 1 h) to 14.53% (after 4 h); at 514.5 nm it ranged from 0.96% to 2.14%; at 532 nm it ranged from 0.03% to 0.07%. At lambda > 550 nm, laser absorption was found to be negligible. CONCLUSIONS: In order to optimize the effect of photocoagulation, especially during long photocoagulation sessions, argon blue laser (488 nm) should be avoided following fluorescein angiography. Argon green laser (514.5 nm) should be used within 1 h after fluorescein injection. Frequency-doubled Nd:YAG laser (532 nm), krypton laser (647 nm) or semiconductor diode laser (810 nm) may be used at any time.

Absorption↗
PubMed1996

Spontaneous regression of neovascularization at the disk and elsewhere in diabetic retinopathy.

PURPOSE: To report three cases of spontaneous regression of new vessels of the disk and elsewhere in proliferative diabetic retinopathy. METHODS: We retrospectively examined the clinical records of three young women (27, 26, and 19 years old) with insulin-dependent diabetes mellitus (for 16, eight, and 17 years, respectively) associated with other systemic diseases and referred to us for treatment of retinopathy. Complete general and ophthalmologic findings, visual field, and angiographic and electroretinographic examinations were available for each patient. RESULTS: All the patients showed marked, spontaneous improvement of their proliferative retinopathy, with regression of new vessels. Assessment of metabolic control did not bring to light any noteworthy change during the period when the new vessels disappeared. Regression of new vessels was associated with a marked improvement in blood-retinal barrier breakdown as detected on fluorescein angiograms. CONCLUSIONS: Although very unusual, spontaneous regression of neovascularizations in proliferative diabetic retinopathy can happen. We can offer no explanation for the regression of the new vessels and retinovascular hyperpermeability.

Adult↗
PubMed1995

Central retinal vein and branch artery occlusion associated with inherited plasminogen deficiency and high lipoprotein(a) levels: a case report.

We describe a case of central retinal vein and branch artery occlusion associated with inherited type I plasminogen deficiency (68%) and permanent elevation of Lp(a) (460 mg/l, S2 phenotype) in a 45 year old white woman with no associated local or systemic risk factors. Pedigree analysis revealed inheritance of plasminogen deficiency from the deceased father and of high Lp(a) levels from the mother. Both the patient's sons had plasminogen deficiency, but they had normal Lp(a) levels. In a series of 40 consecutive patients with central retinal vein occlusion we previously reported the observation of high Lp(a) levels--consistently associated with the S2 phenotype--in 30% of the patients as compared to a 10% incidence in controls. This case emphasizes the importance of screening patients with occlusion of the retinal vessels and no associated risk factors for coagulation abnormalities predisposing to thrombosis.

Female↗
PubMed1995

Bovine factor VIII derivative in the treatment of non-proliferative diabetic retinopathy.

The complexity of the pathogenesis of diabetic retinopathy (DR) makes it difficult to produce effective drugs for its treatment. Among the active principles recently suggested, the peptide fraction of bovine factor VIII of the clotting cascade deserves particular attention. Bovine factor VIII derivatives (vascular factor, VF) have been shown to have significant effects on the capillary basement membrane and on vascular endothelium and they are able to stabilise vessel walls. The aim of this study was to assess the effectiveness of VF in diabetic patients with non-proliferative DR. Nineteen consecutive patients (37 eyes) affected by non-proliferative DR were included in the study and randomly assigned to VF or placebo. An ophthalmological examination, colour photographies and a retinal fluorescein angiography were carried out before as well as 3 and 6 months after inclusion. Every eye in the study was classified in accordance with the ETDRS criteria. While the progress of macular oedema and visual acuity was very similar in the two groups (VF and placebo), there was no deterioration, i.e., no change to a worse classification than that at the start, in any of the eyes in the group treated with VF, but deterioration was seen in 19% of the eyes treated with the placebo. On the basis of these results, VF may ensure some protection of the blood-retinal barrier against the harmful influence of diabetic microangiopathy.

Administration, Oral↗
PubMed1994

Biomicroscopy and fluorescein angiography of pigmented iris tumors. A retrospective study on 44 cases.

The classification of pigmented iris tumors is a difficult clinical problem. Based on the retrospective observation of colour photographs and iris angiograms of 44 pigmented iris tumors observed over 19 years, the authors present an original grading scheme with scores depending on both the biomicroscopical and the fluoroiridographic patterns of the tumors. The biomicroscopical parameters considered were: thickening of the iris in the area of tumor, pupillary distortion and/or ectropion uveae and uneven pigment density. The fluoroiridographic parameters were: early visibility of the anomalous tumoral network, hyperfluorescence inside or around the tumor, and dye leakage at sites remote from the mass. Based on the score of each tumor, the 44 cases were divided into 3 groups with the different degrees of malignancy confirmed by either histological examination or by follow-up behaviour. The authors suggest that routine use of biomicroscopic-fluoroiridographic classification of pigmented iris tumors would be useful.

Female↗