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Biomedical subjects

L Spadea

Publications and source records attributed to L Spadea.

At least 19 recordsLinked to original sources
PubMed2001

Treatment of vascular retinopathies with Pycnogenol.

The aim of our study was to investigate the effects of Pycnogenol on the progression of diabetic retinopathy and other vascular retinal disorders. The study consisted of a double-blind phase in which 20 patients were recruited and randomly treated with placebo or Pycnogenol (50 mg x 3/day for 2 months) and an open phase in which another 20 patients were treated with Pycnogenol at the same dose schedule. In total, 40 patients with diabetes, atherosclerosis and other vascular diseases involving the retina were enrolled; 30 of them were treated with Pycnogenol and 10 with placebo. The results demonstrated a beneficial effect of Pycnogenol on the progression of retinopathy. Without any treatment (placebo) the retinopathy progressively worsened during the trial and the visual acuity significantly decreased; on the contrary, the Pycnogenol-treated patients showed no deterioration of retinal function and a significant recovery of visual acuity was also obtained. The fluorangiography showed an improvement of retinal vascularization and a reduced endothelial permeability and leakage in the Pycnogenol, but not in the placebo-treated, patients. The ophthalmoscopy and the electroretinogram (ERG) also confirmed the beneficial effects of Pycnogenol. The mechanism of action of Pycnogenol may be related to its free radical (FR) scavenging, anti-inflammatory and capillary protective activities. It has been suggested that Pycnogenol may bind to the blood vessel wall proteins and mucopolysaccharides and produce a capillary 'sealing' effect, leading to a reduced capillary permeability and oedema formation.

Diabetic Retinopathy↗
PubMed1999

Videokeratographic changes after laser in situ keratomileusis to correct high myopia.

PURPOSE: To evaluate the videokeratographic changes and patterns after laser in situ keratomileusis (LASIK) in high myopia using computerized videokeratography. SETTING: San Salvatore Hospital, Chair of Ophthalmology, University of L'Aquila, L'Aquila, Italy. METHODS: Forty-one eyes of 26 patients treated with no-suture nasal-hinged flap LASIK for an attempted mean spherical equivalent correction of -13.9 diopters (D) +/- 4.1 (SD) (range -8.0 to -22.0 D) were evaluated. Mean patient age was 35.2 +/- 9.8 years. Mean follow-up was 15.1 +/- 6.7 months (range 6 to 26 months). RESULTS: Thirty-five eyes (85.4%) were within +/- 2.0 D of the planned correction, with a refractive error greater than 3.0 D in the 7.3% of eyes. Mean central corneal power decreased from 43.2 +/- 1.8 D (range 38.70 to 47.40 D) to 35.8 +/- 3.8 D (range 30.3 to 42.6 D). Mean preoperative corneal astigmatism decreased from 1.2 +/- 0.9 D (range 0.2 to 4.2 D) to 0.9 +/- 0.9 D (range 0.2 to 3.3 D). Videokeratographic qualitative analysis showed corneal shape changes within 15 days after surgery. Corneal patterns then stabilized, and 37 eyes (90.3%) had no significant modifications in corneal refractive power after 1 month. CONCLUSION: After LASIK in highly myopic eyes, videokeratographic maps showed corneal power stabilized within 1 month in most eyes and there was no irregular astigmatism if the treatment was well centered.

Adult↗
PubMed1998

Unilateral retinitis pigmentosa: clinical and electrophysiological report of four cases.

Unilateral retinitis pigmentosa (URP) is a rare tapetoretinal dystrophy affecting only one eye. The François and Verriest criteria are necessary to make a correct diagnosis of URP: exclude all infective etiologies, check that the clinical signs of retinitis are present in the affected eye and ensure the total absence of any signs or symptoms of retinitis pigmentosa in the fellow eye. The standard electroretinogram and standard electro-oculogram are very useful for the correct diagnosis. Other pigmentary retinopathies simulating retinitis pigmentosa have to be excluded, such as previous retinal inflammatory diseases like syphilis, rubeola, other viral diseases and onchocerciasis. In this paper, 4 cases of URP are reported.

Adolescent↗
PubMed1998

Long-term results of excimer laser photorefractive keratectomy in high myopia: a preliminary report.

BACKGROUND AND OBJECTIVE: To evaluate the results of 193-nm excimer laser photorefractive keratectomy (PRK) performed on highly myopic eyes with a follow-up of at least 2 years. PATIENTS AND METHODS: Fifty-three eyes of 41 patients were treated with a myopic PRK for an attempted correction ranging between -8 and -17 D (mean -10.9 +/- 2.8 SD). RESULTS: The follow-up ranged from 24 to 60 months (mean 34.1 months +/- 10 SD). Fifty-three percent of the eyes achieved a refraction within +/- 2 D of the planned correction, with a refractive error greater than 4 D in 21% of the treated eyes. The uncorrected visual acuity was 20/40 or better in 45% of the eyes. There were no significant opacities in 85% of the eyes examined. A second treatment was performed on 5 eyes. CONCLUSION: The results suggest that excimer laser PRK is a safe and relatively effective alternative for treating highly myopic eyes, and its effects are stable over a long period of time.

Adult↗
PubMed1997

Early detection of P-VEP and PERG changes in ophthalmic Graves' disease.

BACKGROUND: In Graves' disease the optic neuropathy (ON) is due to direct compression of the nerve and/or of its blood supply. The aim of the present study was to detect early changes in the visual functions of patients affected by ophthalmic Graves' disease (OGD) by using electrophysiological tests (P-VEP and PERG). METHODS: We studied 50 OGD patients who were in a range between class 2 and class 5 according to the Donaldson-American Thyroid Association classification, i.e. had no evident ON and normal visual acuity. We recorded transient reversal PERG and P-VEP in response to the stimulation of one eye at three spatial frequencies (2.2, 1.1 and 0.5 c/d). RESULTS: Our results showed a statistically significant reduction in PERG amplitude in class 5, while the P-VEP amplitude was already reduced in class 2. CONCLUSION: The electrofunctional tests were useful to detect small changes in the visual function of patients affected by initial stages of OGD. Therefore, P-VEP and PERG recordings appear to be a useful tool for early diagnosis of the optic nerve involvement in Graves' disease.

Adult↗
PubMed1997

[Electro-functional changes in pseudo-exfoliative syndrome].

PURPOSE: Up to date the pathogenetic aspects of exfoliation syndrome which are not well agreed upon even though the vascular damage plays a major role. METHODS: In order to evaluate the electrophysiological changes occurring in patients affected by exfoliation syndrome a case-control study with pattern electrofunctional examinations and oscillatory potentials from standard flash-ERG in 80 eyes affected by exfoliation syndrome with or without ocular hypertension was undertaken. RESULTS: Some statistically significant PERG, P-PEV and OP abnormalities were found in eyes affected by exfoliation syndrome with or without ocular hypertension (p < 0.001). There is no statistically significant difference between affected and control eyes in monolateral syndrome (p > 0.05). The electrofunctional examination did not mark any statistically significant difference between eyes with and without ocular hypertension (p > 0.05). CONCLUSION: The results stressed by pattern and oscillatory potentials examinations may support the hypothesis of a primitive change of the optic nerve.

Adult↗
PubMed1996

Effect of myopic excimer laser photorefractive keratectomy on the electrophysiologic function of the retina and optic nerve.

PURPOSE: To assess by electrophysiologic testing the effect of photorefractive keratectomy (PRK) on the retina and optic nerve. SETTING: Eye Clinic, S. Salvatore Hospital, L'Aquila University, Italy. METHODS: Standard pattern electroretinograms (P-ERGs) and standard pattern visual evoked potentials (P-VEPs) were done in 25 eyes of 25 patients who had myopic PRK for an attempted correction between 5.00 and 15.00 diopters (D) (mean 8.00 D). Testing was done preoperatively and 3, 6, 12, and 18 months postoperatively. The contralateral eyes served as controls. During the follow-up, 3 patients (12%) developed steroid-induced elevated intraocular pressure (IOP) that resolved after corticosteroid therapy was discontinued. RESULTS: No statistically significant differences were seen between treated and control eyes nor between treated eyes preoperatively and postoperatively. CONCLUSION: Myopic excimer laser PRK did not seem to affect the posterior segment. The transient steroid-induced IOP rise did not seem to cause functional impairment.

Adult↗
PubMed1996

Specular microscopy of the corneal endothelium after excimer laser photorefractive keratectomy.

PURPOSE: To evaluate endothelial cell morphology and density after excimer laser photorefractive keratectomy (PRK). METHODS: We used a noncontact specular microscope to examine the central corneal endothelium of 50 eyes of 50 patients who had PRK for an attempted correction between -2.5 and -17.0 diopters (D) (mean -7.8 D) beginning 18 to 24 hours postoperatively. RESULTS: After a follow-up of 11.4 +/- 6.1 months (mean +/- standard deviation), mean endothelial cell density was 2577.6 +/- 402.0 cells/mm2 with rare signs of polymegathism and pleomorphism. Preoperative and untreated fellow eye endothelial cell density values were used as a control. Paired Student's t-test and analysis of variance results were not significant (P > .05). CONCLUSION: Excimer laser PRK did not significantly change cell density and morphology.

Adult↗
PubMed1996

Penetrating keratoplasty with donor and recipient corneas of the same diameter.

BACKGROUND AND OBJECTIVE: A retrospective study was conducted to investigate the effect of penetrating keratoplasty (PK) with donor and recipient corneas of equal diameter on astigmatism, corneal curvature, and spherical equivalent. PATIENTS AND METHODS: A total of 89 eyes of 86 consecutive patients who underwent PK with donor and recipient corneas of equal diameter were studied. The surgical techniques were performed using the Hanna suction punch block (endothelial cut) with the trephine system, and a single running 16-bite 10-0 nylon suture. Sixteen eyes underwent a triple procedure (PK, extracapsular cataract extraction, and intraocular lens [IOL] insertion) and 14 eyes underwent PK with sulcus fixation of a posterior chamber IOL. Follow-up ranged from 12 to 30 months (mean +/- SD 17.5 +/- 4.7). The sutures were removed at approximately 12 months postoperatively. RESULTS: The postoperative astigmatism ranged from 0.4 to 10.8 D (mean +/- SD 4.5 +/- 2.8), as evaluated by a computer-assisted videokeratograph topography unit. Twenty-seven eyes (30.3%) achieved a refractive error (spherical equivalent) within +/- 1.5 D of emmetropia. The mean postoperative refractive error (spherical equivalent) was -0.1 +/- 3.5 D (range -6.75 to + 7.25). No wound dehiscences or glaucoma was noted during the follow-up. CONCLUSION: The Hanna suction system creates a sharp, deep, and perpendicular cut on both button cornea and host cornea, making it possible to use donor and recipient corneas of the same diameter in PK with good clinical and refractive results, particularly for myopic (keratoconus) patients.

Astigmatism↗
PubMed1994

Electro-oculographic changes after local excision of uveal melanoma.

Standard electro-oculography was performed in 10 patients with malignant unilateral uveal melanoma All eyes were treated by means of surgical local excision. After a mean +/- standard deviation follow-up of 10.5 +/- 5.5 months (range, 6 to 20 months) in the five patients with choroidal melanoma, the electro-oculographic recordings, which had appeared reduced or flat before the surgery, increased significantly just after the local excision. Thereafter the amplitudes of the electro-oculographic light peaks were reduced in all cases up to extinction, possibly because of a retinal detachment. On the contrary, the electro-oculographic value in the five melanomas localized at the iris and ciliary body, normal before the surgery, showed a marked and persistent increase after surgery, probably related to an 'electric hole' in the globe.

Electrooculography↗
PubMed1994

Electroretinographic findings in congenital oculomotor apraxia (Cogan's syndrome).

We performed visual evoked potential testing and electroretinography in five patients with Cogan's oculomotor apraxia. The visual evoked potentials were normal, confirming previously reported data. Electroretinograms were abnormal in two of the five patients examined. A previous study showed normal electroretinogram responses bilaterally in one patient. Our findings suggest the existence of two variants of the syndrome; the one with electroretinogram anomalies has a worse visual prognosis.

Apraxias↗
PubMed1991

Evaluation of electrofunctional data following argon-laser trabeculoplasty in primary open-angle glaucoma.

To establish whether or not glaucomatous damage is reversible, we obtained pattern-reversal electroretinograms (PERGs) and visual evoked potentials (VEPs) in 25 eyes of 25 patients suffering from bilateral primary open-angle glaucoma (POAG) before and after argon-laser trabeculoplasty. The laser treatment was carried out in only one eye chosen at random, and the fellow eye was used as a control. In the present study we intended to verify the possibility of using electrofunctional techniques to determine the two distinct and, probably, consecutive glaucomatous alterations occurring in ganglion cells: functional (reversible) and anatomical (irreversible). The results obtained indicate that glaucomatous damage is irreversible. We propose that such alterations differ very slightly and that the current electrofunctional techniques may not be sufficiently sophisticated to distinguish between them.

Adult↗
PubMed1986

Steroids and neuroendocrine hormones detected by the immunoperoxidase technique from malignant melanomas and nevi of the choroid and conjunctiva.

By the peroxidase-antiperoxidase technique, the authors studied 7 malignant choroidal melanomas, 7 conjunctival nevi and 1 malignant conjunctival melanoma with the aim to detect the presence of vasoactive intestinal polypeptide (VIP), adrenocorticotropic hormone (ACTH), gastrin, estradiol and testosterone. Positive staining reaction for VIP, estradiol and testosterone was observed in both malignant melanomas of the choroid and conjunctival nevi. The case of conjunctival melanoma was positive for VIP and ACTH but not for estradiol and gastrin.

Adolescent↗
PubMedDate not supplied

Normal EOG values in intraretinal metastasis from cutaneous melanoma: a case report.

PURPOSE: The electro-oculogram (EOG) is a powerful test to diagnose primary and metastatic choroidal tumors. While in benign tumors light-peak to dark-trough ratio values are in the range of normal subjects, these values appear highly altered in eyes affected by malignant choroidal tumors. Here we report a clinical case of a patient with intraretinal metastasis from cutaneous melanoma; notwithstanding the malignancy of the tumor, the EOG doesn't present alterations. METHODS AND RESULTS: Standard electro-oculographic recordings were performed before and after local excision of the tumor: recordings from the normal eye were taken as control. The EOG values were always normal in both eyes. Histological sections showed no evident change in the cell population of the retinal pigment epithelium (RPE) and Bruch's membrane. CONCLUSION: Our results suggest that the presence of an intact RPE is a crucial requirement to obtain a normal EOG.

Adult↗
PubMedDate not supplied

Electro-oculographic abnormality in eyes with uveal melanoma.

PURPOSE: To seek out correlations between preoperative electro-oculogram (EOG) recordings with different types of uveal melanomas, after surgery. METHODS: We analysed the EOG recordings of 120 patients with uveal melanomas, histologically verified, 100 in the choroid and 20 in the iris and ciliary body. The EOG data were correlated with the site, size and histological type of the tumor. RESULTS: In 100 eyes with choroidal melanoma the Arden Index (AI) was less than in fellow eyes (mean 126.6, SD +/- 23.8 and 202.9, SD +/- 47.0; p=0.01). The EOG values were not different with respect to the histological type, site and size of tumor. In cases with iris and ciliary body melanomas the AI were not significantly different from the fellow eyes (mean 180.6, SD +/- 23.6 and 203.2, SD +/- 38.7; p=0.07). CONCLUSIONS: Since the EOG is abnormal in eyes with choroidal melanoma, it can be considered a powerful auxiliary for diagnosing these tumors.

Adult↗
PubMedDate not supplied

Malignant conjunctival epibulbar fibrous histiocytoma with orbital invasion.

The Authors report on a rare case of malignant conjunctival epibulbar fibrous histiocytoma with orbital invasion. Fibrous histiocytoma is a tumour of mesenchymal origin, which, although among the most common adult age soft tumours, appears very rarely at the conjunctival level. In fact the most frequent site is the orbit. So far only 15 cases concerning conjunctiva have been described in the Literature only 4 of those have been reported as malignant. We observed a male patient, who 6 years ago, at the age of 53, noticed a neoformation on the temporal portion of the bulbar conjunctiva. In June 1988, after three successive operations, with a histological diagnosis of inflammatory granuloma, he came to our Clinic, where, because of the characteristics of the orbit infiltrations, only a partial excision was carried out for a biopsy. The histological examination, associated with immunohistochemical techniques, gave the result of malignant fibrous histiocytoma. Consequently in, July 1988, the patient underwent an exenteratio orbitae. To date, the patient enjoys good health without a trace of recurrence. Besides the clinical presentation of the case, histopathological and immunohistochemical findings concerning this type of lesion are presented and discussed, with a comparison of our findings with those reported in the literature.

Conjunctival Neoplasms↗
PubMedDate not supplied

PERG and P-VEP after surgical trabeculectomy in primary open-angle glaucoma.

Pattern-reversal electroretinograms (PERG) and visual evoked potentials (P-VEP) were measured for 10 eyes from 10 rigorously selected patients with bilateral advanced primary open angle glaucoma (POAG), before and after surgical trabeculectomy. The aim was to establish whether electrofunctional examinations improved after major IOP reduction. Only one eye at random was operated, and the fellow eye was used as control. The aim of this study, using electrofunctional examinations, was to clarify whether ganglion cell damage was reversible after marked reduction of IOP by surgery. The results indicate that glaucomatous damage seems to be irreversible.

Adult↗