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Biomedical subjects

L Pierro

Publications and source records attributed to L Pierro.

At least 19 recordsLinked to original sources

Choroidal calcifications in patients with Gitelman's syndrome.

Gitelman's syndrome is a renal tubular disorder characterized by a sodium and chloride reabsorption defect in distal tubular cells that determines hypokalemia, metabolic alkalosis, hypomagnesemia, and low calcium excretion. The presence of choroidal calcifications was sought in five patients with Gitelman's syndrome by ophthalmic examination, fluorescein angiography, indocyanine green angiography, and ocular ultrasonography. Calcifications observed in the choroid of two patients were shown by ultrasonography in both patients. Ophthalmic and fluorangiographic examinations detected this alteration in one of the two subjects. Chondrocalcinosis was found in one patient with choroidal calcifications. These findings suggest that precipitation of calcium salts can occur in the choroidal tissue of patients with Gitelman's syndrome. Deposits appeared to be well seen by ultrasonography because of their depth in ocular tissues. Sclerochoroidal calcifications may be favored by the low calcium excretion, which is associated with normal intestinal calcium absorption in patients with Gitelman's syndrome.

Adolescent↗

Axial length in patients with diabetes.

PURPOSE: To investigate the relationship between axial length and retinal involvement in patients with diabetes. METHODS: A total of 157 consecutive patients with diabetes underwent biometry. The patients were divided into three groups, according to retinopathy: 44 without retinopathy, 37 with background retinopathy, and 76 with proliferative retinopathy. To compare axial length in diabetic versus nondiabetic subjects, a control group of 157 healthy subjects with age and sex distribution similar to the diabetic group was selected from an orthopedic clinic. We investigated in the diabetic group whether the axial length was related to specific type of diabetes (non-insulin-dependent or insulin-dependent), duration of disease, presence of retinopathy, or laser treatment. To eliminate the confounding effect of myopia, we excluded all patients with axial length greater than 24 mm from the two groups. Comparison of diabetic patients without retinopathy versus nondiabetic subjects was also performed. RESULTS: Diabetic patients presented shorter axial lengths compared with the controls (mean +/- standard deviation, 22.4+/-1.3 mm versus 23.4+/-1.3 mm; P<0.001). Significantly shorter axial lengths were found in the background and proliferative retinopathy groups compared with the group without retinopathy (22.0+/-1.2 mm and 22.1+/-1.1 mm versus 23.2+/-1.4 mm, respectively; P<0.05). No difference in axial length was found between the diabetic patients without retinopathy and the nondiabetic subjects (P = 0.3). Multivariate analyses showed that retinopathy was negatively correlated with axial length (P<0.01). Including only the patients with axial length under 24 mm, we obtained similar results. CONCLUSION: Axial length is shorter in diabetic patients than in nondiabetic subjects. Within the diabetic group, patients with retinopathy had shorter axial lengths than did patients without retinopathy.

Anthropometry↗

Ultrasound biomicroscopic evaluation of ciliochoroidal effusion after laser treatment.

We evaluated ciliochoroidal effusion (CE) by ultrasound biomicroscopy (UBM) following diode endophotocoagulation at the end of the vitreoretinal surgery. The aim of our study was to assess any differences in the CE morphology following diode endophotocoagulation or transpupillary krypton photocoagulation, and to demonstrate the influence of diabetes and intravitreal surgery on CE formation. Sixty-six consecutive patients were divided in to four groups. Twenty-nine patients with proliferative retinopathy underwent transpupillary krypton photocoagulation; 11 diabetic patients underwent vitreoretinal surgery and diode endophotocoagulation; 18 nondiabetics underwent vitreoretinal surgery and diode endophotocoagulation; 8 consecutive nondiabetic patients were the control group and underwent vitreoretinal surgery, without laser treatment. UBM was performed in the four groups before and after laser treatment, if performed. We determined, by UBM, not only the presence, but also the thickness of CE. CE was present in all the patients treated by laser, diabetics and nondiabetics, and its thickness was not correlated with the number of laser spots (p = 0.28). CE was seen ultrasonically in all the patients undergoing transpupillary photocoagulation or endophotocoagulation, regardless of diabetes and surgical trauma.

Aged↗

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↗

High-frequency ultrasound biomicroscopy versus ultrasound and optical pachymetry for the measurement of corneal thickness.

The aim of this study was to correlate central corneal thickness measurements obtained using optical as well as ultrasound pachymeters and high-frequency ultrasound biomicroscopy (UBM), assuming UBM as reference. Each measurement was performed on 32 patients (60 eyes) by three observers unaware of the other's results, on 3 different days. Pearson correlation was used. A strong correlation was found between UBM and ultrasound pachymetry measurements (r=0.858), a weaker one between UBM and optical pachymetry (r=0.506). Optical versus ultrasound measurements were poorly correlated (r=0.540). Each correlation was statistically significant (p<0.001). UBM can be used as an accurate and reproducible method for determining corneal thickness.

Anthropometry↗

Extraocular muscle size comparison between normal and myopic eyes using standardized A scan echography.

The aim of this study was to establish the range of diameters of extraocular muscles in myopic patients and to obtain the baseline data to follow progression or regression of pathologies involving them. Standardized A scan and B scan ultrasound was used to measure the thickness of straight extraocular muscles at the muscle belly. No statistical differences were seen between right and left eyes. We found no consistent correlation with age or with axial length in the control or in the myopic patients (p>0.05). Diameters in myopic and control eyes were similar. This lack of difference between myopic and control muscle sizes means that we can obtain accurate measurements also from myopic patients.

Humans↗

Bilateral occlusion of the central retinal artery in a homocystinuric patient: the role of echography.

The authors describe a case presented by a homocystinuric 26-year-old male patient with bilateral occlusion of the central retinal artery. Echography carried out the same day of the occlusion and the following days identified and monitored a mass located in the orbit of the OD. Characteristics and dimension of the mass were confirmed and measured by a CT scan and NMR examination. The orbital mass of the OD appeared to be a swelling of the central retinal artery with echo-refracting opacities, which, in light of recent studies, can be interpreted as multiple arterial thrombi, composed predominantly most likely by platelets. Therapeutic possibilities are discussed.

Adult↗

Clinical and ultrasound study of peripheral vitreoretinal adhesions.

PURPOSE: To evaluate the frequency of peripheral vitreoretinal adhesions in the region of the vitreous base by ultrasound examination in relation to axial length of the eye and the age of the patient. Patient gender and the presence of visual symptoms also were considered. METHODS: A total of 228 consecutive patients (445 eyes) underwent biometry, ultrasound examination, and biomicroscopic fundus examination. Their medical history also was taken. The patients were divided into three groups according to axial length of the eye (< 24 mm, 24-26.5 mm, and > 26.5 mm) and into three age groups (20-40 years, 41-60 years, and > 60 years). RESULTS: No correlations was found between peripheral vitreoretinal adhesions and gender or between peripheral vitreoretinal adhesions and axial length of the eye. A significant correlation was found between peripheral vitreoretinal adhesions and age (P < 0.001). The proportion of adhesions increased with age (P < 0.001). The association between adhesions and presence of symptoms also was significant (P < 0.001). Multivariate analysis showed that only the presence of symptoms independently correlated with adhesions (relative risk, 1.71, 95%; confidence interval, 1.19, 2.46). CONCLUSION: Our study shows that peripheral vitreoretinal adhesions, detected by ultrasound, were always associated with the presence of symptoms.

Adolescent↗

Correlation of lens thickness with blood glucose control in diabetes mellitus.

The aim of this study was to verify if lens thickness in insulin-dependent diabetic patients is greater than in non-diabetics, and to establish which parameters affect the thickness of the lens age, diabetes duration, glycaemic control, insulin dose. Ultrasound biometry and blood glucose measurements were taken in 87 patients three times a day: fasting 2 and 4 h after lunch. The patient sample was divided into three groups: 30 with no retinopathy, 30 presented background retinopathy and 27 with proliferative retinopathy; 30 normal subjects with a similar age to the diabetic group, comprised the control group. No correlation was found between biometric values and blood glucose in the three groups (p < 0.05). A significant difference in lens thickness was found in the four groups, even after adjusting for age (p < 0.05). Significant differences in lens thickness were seen between proliferative retinopathy and the other groups, after adjusting for age and duration of diabetes (p < 0.05); lens thickness was shown to correlate with diabetes duration (p < 0.05).

Adult↗

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↗

Correlation of corneal thickness with blood glucose control in diabetes mellitus.

The aim of this study was to prove the existence of a correlation between corneal thickness and glycaemic control in insulin-dependent patients. Ultrasound pachometry and blood glucose measurements were taken in 87 patients three times a day: fasting, two, and four hours after lunch. The sample was divided into three groups of patients: 30 of them did not have retinopathy, 30 presented background retinopathy and 27 proliferative retinopathy. Thirty normal age-matched subjects were the control group. No correlation was found between pachometry values, blood glucose and duration of diabetes in the three groups (p > 0.05). A significant increase in corneal thickness was found in patients with background and proliferative retinopathy compared to the others (p < 0.01). No corneal thickness differences resulted between background and proliferative retinopathy (p = 0.74).

Adult↗

Prenatal detection and early diagnosis of hereditary retinoblastoma in a family.

A couple asked for prenatal testing, the husband being a retinoblastoma survivor. Family history suggested that the tumor predisposing mutation came from his paternal side. DNA analysis indicated that the foetus had not inherited that mutation. Detection of a regressed retinoblastoma in the husband's mother changed the interpretation of the haplotypes obtained, and it was concluded that the foetus had inherited the mutation. Ultrasonography on the 3rd day of extra-uterine life showed a retinal mass in the newborn's left eye. Two years later, the couple asked for a new prenatal diagnosis. DNA analysis showed that the foetus had inherited the mutant retinoblastoma haplotype from the father. Fundus examination on the 2nd day of extra-uterine life showed a retinal lesion in the newborn's left eye at the posterior pole. This case indicates the necessity of a thorough check on history and an ophthalmological examination of family members.

Adult↗

Ocular involvement in acute lymphoblastic leukemia: an echographic study.

We report a case of acute lymphoblastic leukemia (ALL) with ocular involvement in which bilateral swelling of the optic disk head was noticed. Massive direct infiltration of the optic nerve head by leukemic cells can give rise to a clinical picture identical to that of a true papilledema. Ocular echography allowed a better and more complete interpretation of the optic disk involvement. No echographic description of a leukemic infiltration of the optic nerve head has been reported previously.

Adult↗

Peripheral retinal changes and axial myopia.

The relationship between the presence of peripheral chorioretinal changes and axial myopia in 513 eyes (513 patients) 24 mm or more in length, or beyond the upper range of normal axial length, is studied. Axial length was measured with A-scan ultrasonography (immersion technique) and retinal periphery was studied by biomicroscopic examination and scleral indentation. The presence of lattice degeneration, pavingstone degeneration, pigmentary degeneration, white with or without pressure (WWP), retinal holes, tears, or both (RHT), retinal detachment, and posterior vitreous detachment was reported. The correlation between presence of a lesion and a longer axial length was always significant, except with retinal detachment, pigmentary degeneration, and RHT. Pavingstone degeneration was significantly related to older age and WWP and RHT to younger age. Posterior vitreous detachment was frequent in almost all axial length groups and age classes. No significant relationship was found between any kind of lesion and gender of the patient, or between axial length and patient age.

Adolescent↗

Capillary and cavernous hemangioma of the optic disc. Echographic and histological findings.

The ultrasonography features of optic disc hemangioma have been described in various reports but the extreme rarity of this ocular tumour makes any univocal interpretation of echographic findings difficult. The two cases of hemangioma of the optic disc described here, one of capillary hemangioma and the other of cavernous hemangioma, presented different echographic patterns. In the capillary hemangioma B-scan showed a mass lesion with smooth anterior border, acoustic solidity and no choroidal excavation. With A-scan there was an initial high spike with low/medium internal reflectivity. In the cavernous hemangioma, B-scan showed an elevated dome-shaped mass, with an anechoic area inside, and no choroidal excavation. With A-scan there was a high initial spike and irregular reflectivity. The eyes were enucleated for intractable neovascular glaucoma. Histological examination of the lesion explained the different echographic patterns. Ultrasonography is useful in the differential diagnosis of capillary and cavernous hemangioma.

Adult↗

Hypertensive choroidopathy: a case report.

The authors report a case of exudative retinal detachment of the posterior pole and peripheral choroidal detachment in a patient with renovascular accelerated hypertension. The peculiar clinical situation of this patient was comparable with experimental models of hypertension recently reported in the literature. Both the retinal and the choroidal detachment regressed after blood pressure stabilization with systemic antihypertensive therapy, supporting a choroidal pathogenesis for the chorioretinal lesions.

Aged↗

Early ultrasonographic diagnosis of hereditary retinoblastoma.

A hereditary retinoblastoma (RTB) was identified by ocular echography in a newborn, whose predisposition to RTB had been assessed based on the family history and DNA testing of the chorionic villi at the eighth week of pregnancy. Ultrasonography was performed during pregnancies without an abnormality being demonstrated. On the third day of life a B-scan examination showed a small membranous lesion in the nasal parapapillary area, whilst on A-scan, the lesion appeared as a hyperreflective peak. Thanks to its early identification, the tumor was successfully treated by photocoagulation.

Eye↗