PubMed Health⌕ Search

Biomedical subjects

L Pierro

Publications and source records attributed to L Pierro.

36 records · Page 2Linked to original sources
PubMed1991

Chronic bilateral dacryo-adenitis in identical twins: a possible incomplete form of Sjögren syndrome.

We report an unusual case of chronic bilateral dacryo-adenitis in 10-year-old identical twin sisters. Both girls presented with bilateral lacrimal gland enlargement and developed moderate xerophthalmia and keratitis. Both the lacrimal and minor salivary gland biopsies showed a non-granulomatous inflammatory infiltration of mono-nuclear cells. All granulomatous diseases and neoplasms could therefore be ruled out and only Sjögren syndrome and very few other forms of chronic dacryo-adenitis remained as possible diagnoses. Both patients and their parents were evaluated for auto-antibodies. Very low titres of smooth muscle antibodies were found in one, antinuclear antibodies in two and anti-dsDNA antibodies in all four members of the family. Even though the titres of antinuclear and anti-dsDNA antibodies increased in one of the sisters, both patients did not develop any sign or symptom of a systemic connective tissue disease. During the 6 years' follow up, both patients showed persistent tarsal gland enlargement but no other symptoms apart from a moderate xerophthalmia and occasional mild keratitis.

Biopsy↗
PubMed1991

Clinical variability in keratometry, ultrasound biometry measurements, and emmetropic intraocular lens power calculation.

We calculated inter-examiner and intra-examiner variability in keratometry and ultrasound biometry when performed by two different examiners. The potential effect on intraocular lens power calculation was also considered. Intra-examiner variability was statistically and clinically significant for axial measurements, particularly in eyes with axial length greater than 24 mm. Thus, variability in biometric examination affected the emmetropic intraocular lens power, especially in myopic eyes.

Adult↗
PubMed1991

Microphthalmos with colobomatous orbital cyst in trisomy 13.

The authors describe a case of trisomy 13 with microphthalmos and colobomatous cyst of the optic nerve and of the chorioretina with orbital extension, in a six-month-old female patient. The colobomatous cyst has been studied by means of computerized axial tomography and ultrasonography in order to follow its evolution. The orbital cyst has not increased in size.

Child, Preschool↗
PubMed1990

Preoperative astigmatic influence on the predictability of intraocular lens power calculation.

The preoperative and postoperative influence of different parameters on the predictability of formulas used for intraocular lens (IOL) power calculation (axial length, corneal dioptric power, IOL malposition, postoperative astigmatism) has been shown by various authors. In this study, we evaluated the preoperative astigmatic influence on the prediction of postoperative refraction in eyes operated on for cataract with IOL implantation. Three hundred and fifty-nine eyes were evaluated after cataract surgery and IOL implantation. We calculated predictive errors of both the Binkhorst and SRK formulas for each eye. Based on the outcome of the predictive errors we divided the eyes into six groups: three of high and three of low predictability. Preoperative astigmatism in these groups was statistically compared (using the Student's t-test). The preoperative astigmatism was always higher in the group with low predictability than in the group with high predictability (P less than .05).

Astigmatism↗
PubMed1990

[Bilateral choroidal osteoma in an aged patient].

The authors report a case of choroidal osteoma in an elderly patient. The affection was bilateral and multifocal. This rare benign tumor mostly affects young females. We report the outcome of the clinical and instrumental examinations leading to the diagnosis of choroidal osteoma. The patient underwent retinal fluoroangiography, A and B-scan ocular ultrasonography, Computerized Axial Tomography (CAT) with and without dye, orbit RNM, and electroretinography. The same investigations were performed 6-7 months after the first control. No changes in the findings were found except for retinal fluoroangiograms that revealed an increased area of the most central lesion in the right eye. Particularly relevant among these diagnostic techniques were ocular ultrasonography and CAT, which revealed the osseous nature of the tumor. Contact B-scan ultrasound examination showed a small number of dense opacities in both eyes. In the retrobulbar area the tumor caused diminution in echo amplitude. A-scan examination showed high reflectivity peaks (100%) corresponding to the lesion that were detectable even with reduced sensitivity of the system and, in the orbit, low reflectivity that confirmed the tumor's enhanced ultrasound absorption. CAT detected small calcified areas corresponding to the location of the lesions. Haematochemical examinations performed at each control to measure blood calcium, phosphate and alcaline phosphatase were in the normal range. Urinalysis also excluded possible systemic affections underlying the chorioretinal pathology. We discuss possible pathogenetical hypothesis focusing on the age and sex of the patient. These factors in fact, rule out both the hypothesis of a osteogenesis inhibiting factor present in the last 20-30 years of age and the hypothesis of endocrine stimulation in female patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

[Comparative evaluation of echography and C.A.T. in diagnosing retinoblastoma].

The comparative efficiency of sonography and computerised axial tomography on the diagnosis of retinoblastoma was assessed in 8 consecutive cases. Ocular echography revealed a 100% sensitivity whereas CT scans gave false negatives in 2 out of the 8 cases (80% sensitivity). The value of ultrasound scanning as the diagnostic test of first choice for suspected retinoblastoma is therefore emphasised.

Child, Preschool↗
PubMed1985

[Hemorheological aspects of diabetic retinopathy].

Among the various factors which contribute to the onset of diabetic retinopathy, modifications both in the retinal vessel walls and the circulating blood volume have been recognized. It cannot be excluded that the indicated hemorheologic alterations and the presence and severity of diabetic retinopathy are independent manifestations, both of them secondary to the metabolic imbalance and not correlated as cause and effect. Nevertheless, the possibility to modify through drugs and an appropriate metabolic control the probably altered hemorheologic situation in diabetes mellitus certainly represents the aim to pursue in order to reduce the severity of diabetic retinopathy.

Blood Viscosity↗
PubMed1984

Diclofenac increases beta-endorphin plasma concentrations.

Plasma and ventricular cerebro-spinal fluid (CSF) Beta-endorphin concentrations were evaluated after chromatographic separation in patients carrying a ventricular shunt before and after the administration of diclofenac or placebo. In the same subjects the ventricular CSF concentrations of the serotonin and the catecholamine metabolites 5-hydroxyindole-acetic acid (5-HIAA), homovanillic acid (HVA) and MOPEG were also evaluated. Plasma, but not ventricular, Beta-endorphin concentrations increased significantly after diclofenac, while placebo was ineffective. No significant changes in ventricular 5-HIAA, HVA or MOPEG levels were observed. These data suggest a role for Beta-endorphin in the analgesic effect of diclofenac.

Adult↗
PubMedDate not supplied

Ultrasound biomicroscopy following the intraocular use of silicone oil.

We evaluated the ultrasound biomicroscopy findings and the amount and location of silicone oil residue in anterior structures of the eye before and after silicone oil removal. We examined the anterior structures in 40 silicone oil 1000 cs-filled eyes at the end of silicone oil tamponade time (mean silicone oil tamponade duration 5.1 months), and in the same eyes after silicone oil removal. High resolution ultrasound biomicroscopy, 50 MHz transducer, 50 microns of resolution, was used. Silicone oil droplets--often not ophthalmoscopically visible--appeared as highly reflective images with after ringing effect. They were present in the anterior structures of the eye in up to 95% of eyes with silicone oil in the vitreous cavity, and in up to 87.5% after careful silicone oil removal. With ultrasound biomicroscopy it was possible to identify small silicone oil droplets with a typical morphological appearance. Once silicone oil is used in vitreoretinal surgery, its complete removal from the anterior structures of the eye is very difficult to achieve later on.

Adolescent↗
PubMedDate not supplied

Macular thickness measured by optical coherence tomography (OCT) in diabetic patients.

PURPOSE: 1) To compare macular thickness (MT) by optical coherence tomography (OCT) in diabetics and controls; 2) to assess the relationship between MT and stage of diabetic retinopathy (DR) and macular edema (ME); 3) to quantify MT changes after laser treatment for ME. METHODS: One-hundred and thirty-seven patients with diabetes mellitus (216 eyes) were admitted to the study and examined by stereo-color fundus photos, retinal fluorangiography and OCT. DR was classified as: 1) no DR (46 eyes: 21.3%); 2) background DR (66 eyes: 30.6%); 3) pre-proliferative DR (50 eyes: 23.1%); 4) proliferative DR (54 eyes: 25%). The study group was then divided into three ME groups: 1) no edema (65 eyes: 30.1%); 2) not clinically significant ME (no CSME) (45 eyes: 20.8%); 3) clinically significant macular edema (CSME) (106 eyes: 49.1%). Three-month follow-up tomograms were taken to evaluate eyes laser-treated only for ME. The control group consisted of 50 eyes of 50 non-diabetic, age- and sex-matched subjects. RESULTS: MT was 369.3 +/- 163.2 microm in diabetics and 161.9 +/- 12.9 microm in controls (p < 0.001). In the four DR groups it was: 1) 211.0 +/- 37.6 microm; 2) 370.8 +/- 159.6 microm; 3) 419.1 +/- 138.2 microm; 4) 456.1 +/- 162.0 microm (p<0.001). In the three ME groups, MT was: 1)227.8 +/- 53.4 microm; 2) 321.8 +/- 124.2 microm; 3) 476.2 +/-146.6 microm (p < 0.001). In the 52 eyes treated with laser photocoagulation of the posterior pole only and with a follow-up > 3 months, MT before and after treatment was 468.2 +/- 83. 17 microm and 372.1 +/- 120.63 microm. CONCLUSIONS: MT was greater in diabetics than controls and tended to increase with DR and ME severity. OCT is a sensitive technique for detecting early diabetic macular abnormalities and quantifying their reduction after laser treatment.

Diabetes Mellitus, Type 1↗
PubMedDate not supplied

Reliability of preoperative ultrasonography evaluation for vitreoretinal surgery.

To evaluate the present level of reliability of common ultrasonography prior to vitreoretinal surgery, we carried out a prospective study to compare preoperative ultrasonography data with direct intraoperative findings. A total of 228 eyes with different vitreoretinal disorders and opaque or clear media were studied. In the group of 187 eyes with tractional retinal detachment (group I), the percentage of agreement between the ultrasonography data and the surgical findings ranged from 77.1% to 92.2%, depending on the pathology. In the group of 41 eyes without retinal detachment (group II), agreement ranged from 90.4% to 100%. The most frequent causes of failure of preoperative ultrasonography were incorrect prediction of macular detachment, partial posterior vitreous detachment, posterior vitreoschisis and vitreoretinal adhesions. The main cause of failure was the presence of multiple complicated echoes in group I, particularly in tractional diabetic retinal detachment. To achieve maximum benefits from ordinary preoperative ultrasonography, the vitreoretinal surgeon must be fully aware of its present level of reliability and general limitations.

Adolescent↗
PubMedDate not supplied

OCT images and surgery of juvenile Macular retinoschisis.

We describe three cases of X-linked juvenile retinoschisis confined to the posterior pole of the eye, one of which surgically treated. In the first two cases, in vivo optical coherence tomography (OCT) had revealed a cleavage plane in both nerve fiber and outer retinal layers. In the two similar operated eyes of the third case, postoperative OCT had revealed the disappearance of macular schisis in the eye with good recovery of visual function after surgery. On the contrary, it had revealed a persistent splitting of the retina in the other eye, not clinically visible, which explained the poor recovery of visual function after surgery. In cases with progressive worsening of macular involvement in X-linked juvenile retinoschisis, highly accurate surgery may be considered, and the pre- and postsurgical OCT monitor of these patients is indicated.

Adolescent↗
PubMedDate not supplied

Optical coherence tomography in idiopathic epiretinal macular membrane surgery.

PURPOSE: To evaluate the usefulness of Optical Coherence Tomography (OCT) images for surgical indication, intraoperative management and postoperative outcome of patients with idiopathic epiretinal macular membrane (IEMM). METHODS: 28 selected eyes underwent surgery for removal of IEMM. The patients' mean age was 57.3 years. The macular region and the IEMMs were studied before and after surgery using OCT, slit-lamp biomicroscopy and fundus photography. The mean postoperative follow-up was 6.2 months (range 1.3-14). RESULTS: Preoperatively, in 12 of the 28 eyes (42.9%) only the OCT images revealed IEMM partially separated from the macula, with tractional focal point(s) of attachment to the macular region. In the other 16 eyes (57.1%) in which IEMMs were totally adherent to the macular region, the membranes were barely visible by OCT in 13 eyes and not visible in three. Intraoperatively, the surgeon was guided in the peeling procedures. A significant correlation (p < 0.001) was found between visual acuity and macular thickness before surgery and at the end of the postoperative follow-up. CONCLUSIONS: OCT images provide very useful information for the surgical indication, intraoperative management and postoperative outcome of patients with IEMM.

Adolescent↗
PubMedDate not supplied

Unilateral macular retinoschisis with stellate foveal appearance in two females with myopia.

Stellate foveal retinoschisis is considered the hallmark of X-linked retinoschisis. We describe the finding of unilateral retinoschisis with stellate foveal appearance in 2 females with myopia who had no evidence of familial disease. Optical coherence tomography (OCT) and fluorescein angiography were obtained in both cases. Neither patient had a family history of low vision, night blindness, or retinal detachment. Visual acuity in the affected eyes was 20/50 and 20/25, respectively. Both fellow eyes had normal fundi, except for mild myopic changes. With OCT, widespread retinal splitting was detected at the posterior pole in the affected eyes, whereas the fellow eyes were normal. In one case, OCT showed that foveal retinoschisis represented the macular involvement of a flat inferior retinoschisis, although this was not clinically apparent. Macular retinoschisis with stellate foveal appearance may rarely be associated with pathologic myopia. OCT was useful to establish the true extension of these macular changes.

Adult↗
PubMedDate not supplied

Optical coherence tomography (OCT) angiomatous prolifieration (RAP) in retinal.

PURPOSE: To verify the utility of optical coherence tomography (OCT) for diagnosing retinal angiomatous proliferations (RAP) in patients with exudative age-related macular degeneration (AMD). METHODS: Multiple cross-sections were taken with OCT from 41 eyes of 39 consecutive patients with AMD and RAP. The presence and the location of the angiomatous complexes had already been documented by fluorescein angiography (FA) and high-speed confocal indocyanine green videoangiography (ICGA). RESULTS: RAP was detectable by OCT scans in all 41 eyes, appearing as a focal hyper-reflecting area in the neuroretinal layers; it was frequently located close to the inner surface of the retinal pigment epithelium (29 eyes [70. 7%]). All eyes had either no or only a low-reflecting OCTsignal surrounding the RAP, caused by serous intraretinal edema. Only 13 eyes (31.7%), however, had large serous retinal detachment (SRD). OCT detected pigment epithelium detachment in 31 eyes (75.6%), but none had underlying choroidal neovascularization. CONCLUSIONS: OCT findings confirm the intraretinal localization of the RAP which are always associated with impressive exudative phenomena. OCT is therefore a useful diagnostic tool, adding information to FA and high-speed ICGA.

Aged↗
PubMedDate not supplied

[Ocular color Doppler echography: the examination technic, identification and flowmetry of the orbital vessels].

We studied the main ocular and retrobulbar vessels with color-Doppler US and report on examination technique, detectability of the vessels and their flow characteristics to define the normal ranges of Doppler spectra for each artery and vein. We comparatively examined both eyes of 20 healthy subjects. Of each eye we studied the ophthalmic artery, the central retinal artery, the ciliary artery, the central retinal vein and the superior ophthalmic vein. The following flow parameters were considered: peak systolic velocity, end-diastolic velocity and resistive index for arteries; maximum and minimum velocity for veins. The examination lasted about 10 minutes per eye--20 minutes for each subject. In all subjects the five investigated vessels were identified in both eyes, and adequate Doppler spectra were obtained. The average peak systolic velocities of ophthalmic, central retinal and ciliary arteries were respectively about 35, 12 and 10 cm/s, with low resistance patterns (resistive index: 0.75, 0.72 and 0.68, respectively). The venous flow, which is usually continuous, may be sometimes influenced by cardiac and respiratory activities: the maximum velocities of superior ophthalmic and central retinal veins were about 6 and 5 cm/s, respectively. Color-Doppler US noninvasively visualizes both ocular and retrobulbar vessels, providing major hemodynamic information from different flow parameters; the knowledge of these parameters in normal conditions can be the basis of hemodynamic studies in many abnormal orbital conditions.

Blood Flow Velocity↗