Biomedical subjects

Giuseppe Ravalico

Publications and source records attributed to Giuseppe Ravalico.

At least 19 recordsLinked to original sources

PubMed2006

Correlation between optic disc area and retinal nerve fiber layer thickness: a study on scanning laser polarimetry with variable corneal compensation.

PURPOSE: To evaluate if a significant increase of the peripapillary retinal nerve fiber layer (RNFL) thickness can be measured in a sample of healthy eyes by means of scanning laser polarimetry with variable corneal compensation (GDx-VCC) as the optic disc (OD) area increases. METHODS: One eye each of 232 healthy subjects (mean age: 57.8 years; range:40-70) was considered. Temporal-superior-nasal-inferior-temporal average (TSNIT Avg) and OD area (area within the ellipse placed on inner border of peripapillary scleral ring) values were collected. Ellipse horizontal and vertical diameters provided on printout were used to estimate OD area using the equation: OD area = pi x horizontal radius x vertical radius. TSNIT Avg values were plotted against OD area and a multiple linear regression including age calculated. RESULTS: Mean OD area was 2.19 mm(2)+/-0.45 (range: 1.23-3.59) and mean TSNIT Avg was 54.3 micro +/- 3.2 (range: 45.8-61.8). Multiple linear regression equation was TSNIT Avg=57.7-0.096 x OD Area-0.055 x Age (Pearson r=-0.146: p=0.086) CONCLUSION: In our sample of healthy eyes, no significant correlation was found between TSNIT Avg and OD area. In spite of a shorter distance between OD and measurement ellipse margins, larger discs did not necessarily show a thicker RNFL. Probably the large inter-subject variability for RNFL thickness, and then for axonal count, was a predominant factor over OD area.

Adult↗

PubMed2006

Subthreshold grid laser treatment of macular edema secondary to branch retinal vein occlusion with micropulse infrared (810 nanometer) diode laser.

PURPOSE: To compare the effectiveness of subthreshold grid laser treatment (SGLT) with an infrared micropulse diode laser with that of threshold grid laser treatment (TGLT) for macular edema secondary to branch retinal vein occlusion (BRVO). DESIGN: Randomized clinical trial. PARTICIPANTS: Thirty-six patients (36 eyes) were randomized either to infrared SGLT (17 eyes) or to krypton TGLT (19 eyes). METHODS: Complete ophthalmic examinations, including determination of visual acuity (VA) with Early Treatment Diabetic Retinopathy Study charts, optical coherence tomography (OCT), and fluorescein angiography, were performed at the time of the study entry and at 6-month intervals, with a planned follow-up of 24 months. MAIN OUTCOME MEASURES: Primary: decrease in mean foveal thickness (FT) on OCT. Secondary: changes of the total macular volume (TMV) over the follow-up, proportion of eyes that gained at least 10 letters (approximately > or =2 lines of VA gain) at the 12- and 24-month examinations, and timing of macular edema resolution. RESULTS: Changes in mean FT and TMV from the initial values were statistically significant for TGLT from the 6-month examination (P<0.001) and for SGLT from the 12-month examination (P<0.001). After 1 year, there was no difference in mean FT and TMV between the 2 groups. At the 12-month examination, 10 patients of the SGLT group (59%) and 11 of the TGLT group (58%) gained at least 10 letters (2 lines) in VA. At the 24-month examination, this gain was achieved by 11 patients (65%) of the SGLT group and 11 (58%) of the TGLT group. Moreover, at the 24-month examination 59% and 26% gained 3 lines in the SGLT and TGLT groups, respectively. CONCLUSIONS: Resolution of macular edema and VA improvement are similar to those obtained with conventional TGLT, but SGLT is not associated with biomicroscopic and angiographic signs. A multicenter randomized clinical trial would be needed to ascertain the real efficacy and the most appropriate settings of SGLT for macular edema secondary to BRVO.

Aged↗

PubMed2006

Subretinal neovascular membrane associated with type 2a idiopathic juxtafoveolar telangiectasis in pseudoxanthoma elasticum.

BACKGROUND: The objective was to report a case of pseudoxanthoma elasticum associated with type 2A idiopathic juxtafoveolar telangiectasis (T2AIJT) complicated by bilateral subretinal neovascular membranes (SRNVM). METHODS: The right eye with juxtafoveal SRNVM and the left eye with subfoveal SRNVM underwent laser photocoagulation and photodynamic therapy respectively. The follow-up duration was 48 months. RESULTS: Best corrected visual acuity was 20/32 in both eyes at baseline, and 20/32 in the right eye and 20/200 in the left eye at the end of the follow-up. Atrophic changes in the retinal pigment epithelium developed around the SRNVM treated with photodynamic therapy (PDT). CONCLUSIONS: Pseudoxanthoma elasticum may be associated with T2AIJT complicated by bilateral SRNVM. Further studies are needed to assess both efficacy and appropriate PDT regime in T2AIJT-related SRNVM, especially if associated with other conditions.

Coloring Agents↗

PubMed2006

Photodynamic therapy for juxtafoveal choroidal neovascularization associated with multifocal choroiditis.

PURPOSE: Evaluation of visual acuity outcome of photodynamic therapy (PDT) with verteporfin for juxtafoveal choroidal neovascularization (CNV) secondary to multifocal choroiditis (MC). DESIGN: Open-label, prospective, interventional case series. METHODS: Seven patients (seven eyes) diagnosed with juxtafoveal CNV associated with MC at the Eye Clinic of Trieste were considered. Inclusion criteria were the presence of juxtafoveal CNV no larger than 5400 microm in greatest linear dimension and best-corrected visual acuity (BCVA) (Snellen equivalent) of approximately 20/200 or better. PDT was performed according to the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) study. The primary outcome was the variation in Early Treatment Diabetic Retinopathy Study (ETDRS) charts visual acuity. In particular, the study considered changes of at least eight letters (approximately <1.5 lines of visual acuity loss) at the 12- and 24-month examinations compared with the baseline examination. Secondary outcomes included fluorescein angiographic features such as progression and area of CNV. RESULTS: At both the 12- and 24-month examinations, three patients (43%) gained at least 1.5 lines of visual acuity, three patients (43%) did not show changes in either direction, whereas visual acuity decreased by 1.5 or more lines from baseline in one patient (14%). The median CNV area was 0.3 mm(2) at baseline and 0.24 mm(2) at the 12- and 24-month controls, respectively. CONCLUSIONS: The positive results of the present study and the absence of treatment-related side effects suggest that PDT may be considered a safe and viable therapeutic option for juxtafoveal CNV for a 24-month period. Further studies including a greater number of patients are needed to confirm these preliminary results.

Adult↗

PubMed2006

Photodynamic therapy of subfoveal choroidal neovascularization secondary to reticular pattern dystrophy: three-year results of an uncontrolled, prospective case series.

PURPOSE: To investigate the effects of photodynamic therapy (PDT) on subfoveal choroidal neovascularization (CNV) secondary to reticular pattern dystrophy (RPD) of the retinal pigment epithelium. DESIGN: Open-label, prospective, interventional case series. METHODS: Thirteen eyes diagnosed with subfoveal CNV associated with RPD were considered. Complete ophthalmic examinations were performed at baseline and thereafter at three-month intervals for three years. Primary outcome measure was the number of eyes with <15 letters loss (approximately <3 lines) at 12, 24, and 36 months, compared with baseline. Secondary outcome measures included CNV progression and number of PDT sessions. RESULTS: Seven eyes showed a decrease in best-corrected visual acuity of at least three lines at three-year examination. Each eye received a median number of treatments of two, zero, and zero in years one, two, and three, respectively. CONCLUSIONS: PDT does not appear to guarantee long-term vision stabilization in RPD-related subfoveal CNV, and alternative therapies should be investigated.

Aged↗

PubMed2006

Internal limiting membrane removal during macular hole surgery: results of a multicenter retrospective study.

PURPOSE: To evaluate the effect of internal limiting membrane (ILM) peeling and other variables in hole closure and functional success rate after idiopathic macular hole surgery. DESIGN: Retrospective, multicenter, observational study. METHODS: The records of 1627 patients operated on for idiopathic macular hole were collected retrospectively from 28 surgeons. All patients underwent a single pars plana vitrectomy and were divided into 2 groups: with and without ILM peeling. Preoperative, intraoperative, and postoperative variables were evaluated. RESULTS: The overall rate of macular hole closure was 94.1% in the ILM peeling group and 89.0% in the no ILM peeling group (P<0.001). The probability of achieving hole closure after surgery is 2.59 times higher if the ILM is peeled (95% confidence interval [CI], 1.71-3.92; P<0.001), 3.12 times higher for holes lasting less than 6 months (95% CI, 1.70-5.71; P<0.001), 4.94 (95% CI, 2.39-10.20) for stage 2 holes, and 2.34 (95% CI, 1.55-3.53) for stage 3 holes than that of patients with a stage 4 hole (P<0.001). CONCLUSIONS: Internal limiting membrane peeling seems to improve hole closure for stage 3 and 4 holes and for long-lasting holes. Higher-stage macular holes and longer duration of symptoms are risk factors for surgical failure. In patients obtaining hole closure, there is no difference in functional results between pseudophakic peeled and not peeled patients, whereas in phakic patients, a better functional result in not peeled patients was seen.

Aged↗

PubMed2006

The effect of ageing on retinal nerve fibre layer thickness: an evaluation by scanning laser polarimetry with variable corneal compensation.

PURPOSE: To evaluate whether a significant age-related thinning of the retinal nerve fibre layer (RNFL) is measurable by means of scanning laser polarimetry with variable corneal compensation (GDx-VCC) in a sample of healthy eyes. METHODS: A sample of 324 eyes of 324 healthy subjects (mean age 56 +/- 14 years, range 21-85 years) underwent a complete ophthalmic evaluation, standard automated perimetry and RNFL scan with the GDx-VCC. Temporal-superior-nasal-inferior-temporal (TSNIT), superior and inferior average (SA and IA) values provided on the printout were collected and their mean value averaged from all eyes and also after separating the eyes by gender and by age decades. The values of the three parameters were plotted against age and linear regression was calculated. RESULTS: Ageing is associated with a significant RNFL thinning (0.08 micro, 0.16 micro and 0.12 micro per year for TSNIT, SA and IA, respectively; p < 0.001). Analysis showed a similar association with age decade (p < 0.001 on anova). For the TSNIT average, a 9.5% thinning from baseline values was estimated for a 65-year lifespan. Corresponding values for SA and IA were 16.2% and 11.7%, respectively. CONCLUSIONS: Analysis by GDx-VCC confirmed previous reports about significant age-related RNFL thinning. However, a lower rate per year was found, probably because GDx-VCC measurements are much more reliable than those obtained with the previous generation of polarimeters.

Adult↗

PubMed2006

Intersession reproducibility of retinal nerve fiber layer thickness measurements by GDx-VCC in healthy and glaucomatous eyes.

BACKGROUND: To assess intersession reproducibility of retinal nerve fiber layer (RNFL) thickness measurements on scanning laser polarimetry with variable corneal compensation (GDx-VCC) in a sample of healthy subjects and glaucoma patients. METHODS: One eye each from 29 healthy and 29 glaucomatous subjects was selected and underwent RNFL scanning by the same operator at baseline and 1 week later. Glaucoma diagnosis relied on the presence of a reproducible defect on automated perimetry. GDx-VCC parameters considered were those available on page 1 of the printout [TSNIT average and standard deviation (SD), superior and inferior average (SA, IA), Nerve Fiber Indicator]. Reproducibility was assessed by calculating coefficient of variation and intraclass correlation coefficient separately for the two groups and for each parameter. The percentage of eyes with an intersession difference in thickness parameters of more than 5% was also calculated. RESULTS: Coefficient of variation was <6% for TSNIT average, SA and IA in both groups. Corresponding values for TSNIT SD in healthy subjects and in glaucoma patients were 13.7 and 11.4%, respectively, whereas for Nerve Fiber Indicator they were 82.9 and 13.3%. Intraclass correlation coefficient ranged from 0.794 to 0.907 in healthy subjects and from 0.924 to 0.972 in glaucoma patients. In healthy subjects, TSNIT average, SA and IA intersession difference was 5% or less in 55-69% of eyes, whereas the value for TSNIT SD was 34.5%. Corresponding values in glaucomatous eyes ranged from 69 to 79.3% for TSNIT average, SA and IA and was 37.9% for TSNIT SD. CONCLUSIONS: Intersession reproducibility of RNFL thickness measurements on GDx-VCC is high, both in healthy and in glaucomatous eyes. In a few cases, however, intersession variation may be larger than 10%. Caution is necessary while interpreting these changes during follow-up, in order to separate physiological variability from real RNFL thickness variations.

Aged↗

PubMed2005

GDx-VCC performance in discriminating normal from glaucomatous eyes with early visual field loss.

BACKGROUND: To evaluate the ability of scanning laser polarimetry with variable corneal compensation (GDx-VCC) in separating healthy from glaucomatous patients with early visual field (VF) loss. METHODS: Sixty-two healthy and 48 glaucomatous age-matched patients with early glaucoma [mean deviation (MD): -1.74dB +/-1.69] underwent complete ophthalmological evaluation, automated achromatic perimetry (AAP) and retinal nerve fiber layer (RNFL) measurement with GDx-VCC. One randomly selected eye from each subject was considered. Glaucomatous VF defects had either Glaucoma Hemifield Test (GHT) outside normal limits or pattern standard deviation (PSD) outside 95% confidence limits. Mean (+/-SD) MD, PSD and GDx-VCC parameters in the two groups were compared by t-test. For each GDx-VCC parameter, area under receiver operating characteristics (AUROC) curve and sensitivity at predetermined specificity > or =80% and > or =95% were calculated. Moreover, the parameter with largest AUROC was evaluated by likelihood ratios (LRs). RESULTS: Mean values for MD, PSD and ten of 14 GDx-VCC parameters were significantly different between the two groups (P<0.001). The three parameters with largest AUROCs were the nerve fiber indicator (NFI) (0.870), superior average (0.817) and normalized superior area (0.816) (P=0.08 for differences between AUROCs). NFI displayed sensitivity values of 80.2% and 60.4% for specificity > or =80% and > or =95%, respectively. At NFI cutoff value of 30, positive LR was 34.9 (95% CI: 4.9-247.6) and negative LR was 0.45 (95% CI: 0.32-0.61). Interval LRs showed large effect on post-test probability for NFI values < or =18 or > or =31. CONCLUSIONS: In our sample of eyes with early VF loss, GDx-VCC showed moderate-to-good discriminating ability. Among the best performing parameters, NFI had the largest AUROC, but several glaucomatous eyes (21, 43.8%) had NFI <30. This suggests that algorithm for NFI calculation requires some refinement when eyes with early VF loss are evaluated.

Aged↗

PubMed2005

Scanning laser polarimetry with variable corneal compensation and detection of glaucomatous optic neuropathy.

BACKGROUND: The aim of this study was to evaluate the ability of scanning laser polarimetry (SLP) parameters provided by commercially available GDx with variable corneal compensator (VCC) to discriminate between healthy and glaucomatous eyes. METHODS: Sixty-five healthy and 59 glaucomatous age-matched patients underwent a complete ophthalmological evaluation, an achromatic automated perimetry (AAP), and SLP with GDx-VCC. One randomly selected eye from each subject was considered. All glaucomatous eyes had reproducible visual field defects. Mean values (+/- SD) of all SLP-VCC parameters measured in the two groups were compared. Area under receiver operating characteristics (AUROC) curve and sensitivities at predetermined specificities of >or=80% and >or=95% for each single parameter were calculated. Moreover, the nerve fiber indicator (NFI) diagnostic accuracy was evaluated calculating positive, negative, and interval likelihood ratios (LRs) at different cutoff values. RESULTS: All SLP parameters were significantly different between the two groups (p<0.001). The NFI showed the best AUROC curve (0.938, SE 0.02) whereas temporal, superior, nasal, inferior, temporal (TSNIT) average was second best (0.897, SE 0.03), and normalized superior area was third (0.879, SE 0.04). At fixed specificity >or=95%, sensitivities ranged from 22% to 79.7% whereas for values >or=80%, sensitivities were in the 44.1-89.8% range. At a cutoff NFI value of 30, positive LR was 17.6 (95% CI: 5.8-53.6) and negative LR was 0.19 (95% CI: 0.11-0.33). Interval LRs for NFI showed that values 40 were associated with large effects on posttest probability. CONCLUSIONS: SLP-VCC allows good discrimination between healthy and glaucomatous eyes. New software-provided parameters NFI, TSNIT average, and normalized superior and inferior areas appear to be reliable in the evaluation of glaucomatous disease. In particular, after evaluation on interval LRs, the NFI showed a high diagnostic accuracy for values 40.

Aged↗

PubMed2005

Visualization of fluid turbulence and acoustic cavitation during phacoemulsification.

PURPOSE: To describe a technique for visualizing fluid turbulence and cavitational energy created by ultrasonic phaco tips. SETTING: University Eye Clinic of Trieste, Trieste, Italy. METHODS: Generation of cavitational energy by the phaco tip was visualized using an optical test bench comprising several components. The technique uses a telescope system to expand a laser light source into a coherent, collimated beam of light with a diameter of approximately 50.0 mm. The expanded laser beam shines on the test tube containing the tip activated in a medium of water or ophthalmic viscosurgical device (OVD). Two precision optical collimators complete the optical test bench and form the system used to focus data onto a charge-coupled device television camera connected to a recorder. RESULTS: Images of irrigation, irrigation combined with aspiration, irrigation/aspiration, and phacosonication were obtained with the tip immersed in a tube containing water or OVD. CONCLUSIONS: Optical image processing enabled acoustic cavitation to be visualized during phacosonication. The system is a possible means of evaluating a single phaco apparatus power setting and comparing phaco machines and techniques.

Acetates↗

PubMed2005

Scanning laser polarimetry of nerve fiber layer thickness in normal eyes after cataract phacoemulsification and foldable intraocular lens implantation.

PURPOSE: To assess the effect of cataract phacoemulsification and intraocular lens (IOL) implantation on retinal nerve fiber layer (RNFL) thickness using scanning laser polarimetry (SLP). SETTING: Eye Clinic, Trieste University, Italy. METHODS: Forty-eight eyes were evaluated prospectively the day before and 30 days after cataract phacoemulsification and foldable IOL implantation. In each eye, lens opacity grading according to the Lens Opacities Classification System III (LOCS III), and axial length (AL) measurements were performed. Retinal nerve fiber layer thickness was quantified at baseline by means of SLP and anterior segment birefringence compensation was evaluated acquiring macular retardation map (MRM). Acrylic and silicone IOLs were implanted randomly. After surgery, RNFL thickness was reevaluated, and MRM was reacquired. Macular retardation map pattern variations regarding baseline profile were classified into 3 groups: no variation, bow-tie profile enhancement, or attenuation. Distribution of IOL power, AL, and cataract type in the 3 groups was assessed, as were presurgery and postsurgery SLP parameters with mean values (+/-SD) compared by paired t test. RESULTS: Twenty-two eyes (Group 1, 45.8%) showed no MRM variation, 14 (Group 2, 29.2%) an enhancement, and 12 (Group 3, 25%) an attenuation. In Group 1, no significant RNFL thickness variation occurred. In Group 2, variation 10% to 15% was measured, whereas thickening a 8% to 15% thinning appeared in Group 3. Variations occurred irrespective of IOL material, AL, or cataract type. CONCLUSIONS: Cataract surgery with IOL implantation was associated with an MRM profile change and RNFL thickness variations in 54.2% of eyes. Variations are probably related to opacified lens removal. A new baseline SLP reading is mandatory after cataract surgery.

Acrylic Resins↗

PubMed2005

Anatomical and functional outcomes after heavy silicone oil tamponade in vitreoretinal surgery for complicated retinal detachment: a pilot study.

PURPOSE: To evaluate the effectiveness and safety of a heavy silicone oil (HSO) tamponade for complicated retinal detachment (RD) surgery. DESIGN: Prospective consecutive interventional case series study. PARTICIPANTS: The study included 26 patients with RD complicated by severe proliferative vitreoretinopathy (PVR) in the inferior quadrants. METHODS: All patients underwent pars plana vitrectomy with an internal tamponade using HSO. This tamponade was obtained by mixing 30% by volume perfluorohexyloctane and 70% by volume silicone oil, 1000 millipascal-seconds (polydimethylsiloxane 1000). MAIN OUTCOMES MEASURES: Anatomical and functional results and complications at 1 year of follow-up. RESULTS: Twenty-four of 26 patients achieved anatomical success, defined as complete retinal reattachment. Postoperative visual acuity (VA) values ranged from hand movements to 20/25, with 69.2% of patients obtaining VA better than 20/400. Postoperative complications included early postoperative ocular hypertension in 30.7% of cases, which was easily controlled. Dispersion was noted in 1 case and was not felt to be significant. A cataract requiring surgical removal developed in 2 cases, and an after cataract developed in 3 cases. CONCLUSIONS: In this pilot study, the HSO tamponade obtained by mixing 30% perfluorohexyloctane and 70% polydimethylsiloxane 1000 was associated with a high rate of anatomical success after vitrectomy in cases of RD complicated by severe PVR (greater than CP-6 and greater than CA-6 [updated Retina Society PVR classification]).

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PubMed2005

Staining of the internal limiting membrane with intravitreal triamcinolone acetonide.

PURPOSE: To evaluate the use of triamcinolone acetonide to stain the internal limiting membrane (ILM) during vitreoretinal surgery. METHODS: A prospective clinical interventional case series study was performed, including 16 patients who underwent pars plana vitrectomy. Seven patients had proliferative diabetic retinopathy with macular edema. Seven patients had epiretinal membranes. One patient had a retinal detachment with a cystoid macular edema and proliferative vitreoretinopathy. One patient had a pseudophakic cystoid macular edema. After vitrectomy, 2 mL triamcinolone acetonide suspension was injected into the vitreous cavity. The ILM was peeled, as it was evidenced by the particles of triamcinolone that adhered to its surface. The ultrastructure of tissue harvested during surgery was analyzed using transmission electron microscopy in selected cases to confirm the presence or absence of ILM. RESULTS: After the injection of triamcinolone, the visualization of the vitreous base and hyaloid was excellent in all patients. The particles of triamcinolone deposited on the retinal surface enabled the ILM to be stained. Once removed, the ILM was clearly distinguishable, floating in the vitreous cavity with particles of triamcinolone adhering to its surface. Ultrastructural analysis of tissue collected during vitrectomy confirmed that the removed tissue represented ILM. CONCLUSION: We observed that triamcinolone acetonide can be useful in staining the internal limiting membrane, thus greatly facilitating the retinal ILM peeling. The absence of particles of triamcinolone on the underlying retina enables the area where the ILM has already been removed to be identified.

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PubMed2005

MMP-9 microsatellite polymorphism and susceptibility to exudative form of age-related macular degeneration.

PURPOSE: To assess if a polymorphism (PM) of the microsatellite (CA(13-27)) in the promoter region of Matrix Metalloproteinase 9 (MMP-9) was associated with the exudative form of age-related macular degeneration (AMD) and to its risk factors. METHODS: In 107 patients with AMD (AMD Group) and 223 age- and gender-matched controls (Control Group) with cataract, demographic, clinical data, and MMP-9 PM have been compared. RESULTS: The comparison of allelic frequencies showed a different pattern of CA repeats between AMD and Control Group (P < 0.00005), in particular the prevalence of longer microsatellites (> or = 22 CA repeats) was higher in AMD than in Control Group (O.R. 2.49, 95% CI 1.71-3.37, P < 0.001). Analyses of genetic frequencies gave similar results. Logistic regression confirmed that 22 or more CA repeats are associated to AMD. The only association between MMP-9 PM and other risk factors for AMD was with BMI (Spearman's R = 0.298, P < 0.00005): all patients with both microsatellites > or = 22 CA repeats were overweight or obese (chi2 test P < 0.0005, compared to other genotypes). CONCLUSIONS: Longer microsatellites in the promoter of MMP-9 are associated to the exudative form of AMD and to body mass index, a well-known risk factor for the disease.

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PubMed2005

Tissue reaction to hydrophilic intraocular lenses.

The implant of intraocular lenses (IOLs) following cataract surgery induces a foreign body reaction to the IOL and a lens epithelial cell reaction. The host response to the IOL is mainly influenced by biomaterial properties. With the increasing use of phacoemulsification and small incision cataract surgery, there is growing interest in the use of foldable IOLs made of different materials. Hydrophilic acrylic IOLs include a wide group of foldable biomaterials different in terms of water content. These lenses have been reported to show a good biocompatibility after implantation. Nevertheless, tissue reaction to the implant of hydrophilic lenses is variable and not directly related to the hydrophilicity of their surface. A different adsorption of proteins on the IOL optic surface might be responsible for the different cellular reaction and lens epithelial cell response. Other properties besides hydrophilicity should be taken into account to classify IOL biomaterials.

Biocompatible Materials↗

PubMed2004

Early neovascular bridging after photodynamic therapy of myopic choroidal neovascularization.

BACKGROUND: Photodynamic therapy is a relatively new modality for the treatment of subfoveal choroidal neovascularization (CNV). An unusual response to verteporfin therapy of myopic CNVs is reported. METHODS: Out of 187 CNVs secondary to pathologic myopia treated with photodynamic therapy, three eyes manifested two separate foci of CNV before treatment. The three eyes were treated with verteporfin therapy according to the standard protocol, using a single spot of light that covered both neovascular fronds. RESULTS: All the three eyes showed neovascular bridging of the two separate neovascular complexes 1 month after treatment. CONCLUSIONS: Eyes with multiple foci of myopic CNV may show unexpected outcomes after verteporfin therapy. Several factors, such as changes of the retinal pigment epithelium and choroidal vasculature involved in the treatment and enhanced expression of vascular endothelial growth factor, may play a role.

Choroidal Neovascularization↗

PubMed2004

Photodynamic therapy with verteporfin for subfoveal choroidal neovascularization associated with multifocal choroiditis.

PURPOSE: Evaluation of visual acuity outcomes of photodynamic therapy with verteporfin for subfoveal choroidal neovascularization (CNV) secondary to multifocal choroiditis. DESIGN: Open-label, prospective, interventional case series. METHODS: Thirteen patients (13 eyes) diagnosed with subfoveal CNV associated with multifocal choroiditis at the Eye Clinics of Trieste and Udine were considered for the study. Inclusion criteria were the presence of subfoveal CNV no larger than 5,400 microm in greatest linear dimension and best-corrected visual acuity, Snellen equivalent, of approximately 20/400 or better. The primary outcome was the number of eyes that had fewer than 8 letters lost (less than approximately 1.5 lines) at the 12-month examination compared with the baseline examination. Secondary outcomes included fluorescein angiographic features such as progression and CNV size. RESULTS: Baseline and final best-corrected visual acuity were 0.52 logarithm of the minimal angle of resolution (20/62(-2) Snellen equivalent) and 0.55 logarithm of the minimal angle of resolution (20/62(-2) Snellen equivalent), respectively. By the 12-month visit, one patient (7.7%) had gained at least 1.5 lines, two patients (15.4%) had lost 1.5 or more lines, and no patient lost 3 or more lines of visual acuity, whereas 10 patients (84.6%) showed less than 1.5-line change. Mean CNV area was 0,69 mm(2) and 0.63 mm(2) at baseline and at the 12-month visit, respectively. By the month 12 examination, patients had received an average of 1.7 treatments. CONCLUSIONS: Photodynamic therapy may be considered a viable therapeutic option for subfoveal CNV associated with multifocal choroiditis at least for a 1-year period. Further studies with longer follow-up are needed to confirm these results.

Adult↗