Biomedical subjects

M Ciancaglini

Publications and source records attributed to M Ciancaglini.

49 records · Page 3Linked to original sources

PubMed1994

Aqueous misdirection syndrome: a complication of neodymium: YAG posterior capsulotomy.

A 50-year-old, white, pseudophakic man who had a neodymium:YAG (Nd:YAG) posterior capsulotomy for capsule opacification developed a persistent rise in intraocular pressure (IOP) associated with a flat anterior chamber. Full-thickness patent iridotomy performed with an Nd:YAG laser did not reduce IOP. A-scan ultrasonography showed aqueous pockets in the vitreous, leading to a diagnosis of malignant glaucoma. Medical therapy comprising atropine, phenylephrine, mannitol, and acetazolamide normalized IOP and resolved the clinical findings.

Anterior Chamber↗

PubMed1994

Effectiveness of intraoperative mitomycin C in the treatment of recurrent pterygium.

The effectiveness of intraoperative administration of mitomycin C and the occurrence of postoperative complications have been evaluated in 30 white patients with one recurrence of pterygium. The authors employed the 'bare-sclera technique' and, intraoperatively, placed in the episcleral space for 3 min a sterile sponge soaked in a 4% mitomycin C solution. The control group (30 patients with one recurrent pterygium) underwent only surgical excision. Statistical analysis performed using the chi-square test showed a significant (p = 0.024) reduction of recurrences of pterygium in the group treated intraoperatively with mitomycin C. No heavy side effects occurred during the follow-up period. Mitomycin C, administered intraoperatively, may be considered an effective treatment to improve the success rate after surgical excision.

Adult↗

PubMedDate not supplied

The effectiveness of dapiprazole in preventing exercise-induced IOP increase in patients with pigmentary dispersion syndrome.

PURPOSE: The authors investigated the use of dapiprazole, an alpha-adrenergic blocking agent, in preventing pigment release and IOP increase after exercise in patients affected with PDS. METHODS: Three young myopic males (31, 34 and 35 years old) affected with pigmentary dispersion syndrome performed 30 minutes of jogging on a computerized treadmill. Telemetric heartbeat measurement was performed to obtain constant pulse rate training. Computerized tonography and IOP measurement were performed 10 minutes after the exercise. After one month the patients repeated the same exercise after pre-treatment with dapiprazole 0.5% eyedrops (one drop 30, 20 and 10 minutes before the exercise). Ten minutes after the exercise IOP measurements and computerized tonography were repeated. RESULTS: After 30 minutes of exercise IOP measurements showed values ranging from 19 to 45 mmHg (mean 30.33; SD 8.73). Computerized tonography C values after exercise ranged from 0.04 to 0.16 (mean 0.09; SD 0.04). After pre-treatment with dapiprazole 0.5% eyedrops, IOP values ranged from 18 to 28 mmHg (mean 23.33; SD 3.44) and tonography C values ranged from 0.10 to 0.20 (mean 0.14; SD 0.03). CONCLUSIONS: The study supports the concept that exercise-induced pigment release temporarily obstructs the acqueous outflow channels, causing IOP increase in some patients with PDS. Pre-treatment with dapiprazole was useful in reducing IOP spikes and in increasing tonographic total outflow facility after exercise. The absence of induced myopia and the lack of dangerous vitreoretinal tractions on retinal periphery make dapiprazole a safe method to reduce exercise-induced pigment dispersion.

Administration, Topical↗

PubMedDate not supplied

Reproducibility of nerve fiber layer thickness measurements using optical coherence tomography in silicone oil-filled eyes.

PURPOSE: To evaluate the reproducibility of nerve fiber layer (NFL) thickness measurements by optical coherence tomography (OCT) in individuals with silicone oil-filled eyes. METHODS: Eighteen patients who had undergone pars plana vitrectomy and silicone oil tamponade for retinal detachment were enrolled in a prospective, case-controlled clinical study. Each patient underwent OCT measurement of NFL thickness. Five repetitions of a series of scans on five separate occasions within a 0.5-month period were performed. Each eye was scanned at two different nerve head programs [radius (R) = 1.5 and R = 1.73]. The contralateral healthy eye was used as control. For each option (R = 1.5 and R = 1.73) and region (superior, inferior, temporal, nasal and overall mean), variance components and intraclass correlation coefficients (ICCs) were determined using repeated-measures regression. In these models, NFL thickness, as measured by OCT, was considered to have three variance components: intersubject, intervisit (within subject, between dates), and intravisit (within subject, within date). The ICC (intersubject variance/total variance) was used as a measure of reliability. RESULTS: The contralateral healthy eye provided a higher degree of reproducibility than the silicone oil-filled eye (p = 0.0001). Reproducibility was higher in a given eye on a given visit than from visit to visit. Reproducibility as measured by ICCs was as follows: R = 1.5, 0.54/0.30 (control eyes/silicone oil-filled eyes); R = 1.73, 0.51/0.30. CONCLUSIONS: Reproducibility results for OCT measurement of NFL thickness are different in healthy eyes and silicone oil-filled eyes. NFL thickness measurement is not reliable in silicone oil-filled eyes.

Case-Control Studies↗

PubMedDate not supplied

Management of scleral rupture during retinal detachment surgery: a case report.

PURPOSE: Rupture of the sclera occurring during retinal detachment surgery is generally associated with unfavourable anatomic and visual outcomes. Re-operation after a failed scleral buckle procedure and pre-existing scleral thinning are considered the main risk factors for scleral rupture. CASE REPORT: We describe the management and the favourable outcome of a case of scleral rupture in a 71-year-old woman during re-operation for retinal detachment. CONCLUSIONS: We managed this case of scleral rupture in accordance with current indications concerning the anatomical recovery, by scleral suture and patch graft, restoring IOP by gas tamponade. The positive outcome was partly related to the prompt closure of the retinal hole which led to reattachment, and partly to favourable events such as the moderate intensity of vitreous hemorrhage and the lack of any more serious intraoperative and postoperative complications.

Aged↗

PubMedDate not supplied

Optical coherence tomography and retinal thickness analyzer features of spontaneous resolution of vitreomacular traction syndrome: a case report.

PURPOSE: To report optical coherence tomography (OCT) and retinal thickness analyzer (RTA) findings in a case of spontaneous resolution of vitreomacular traction syndrome. METHODS: Qualitative and quantitative analysis of the macular region was performed with OCT and RTA. RESULTS: In the left eye of a 34-year-old woman with blurred vision, OCT and RTA examination showed a discrete linear signal anterior to the retina with attachment at the macula and secondary cystoid macular changes. OCT and RTA examination showed an increase in macular thickness (350 microm). Six months later the patient showed a spontaneous complete recovery of visual acuity. Vitreomacular traction and cystoid changes were no longer detectable at OCT and RTA examination; retinal thickness was normal (205 microm) and a posterior vitreous detachment was visible. CONCLUSIONS: Both OCT and RTA were useful tools for making the diagnosis of vitreomacular traction syndrome and demonstrating the effect of spontaneous vitreomacular traction release with resolution of cystoid macular changes.

Adult↗

PubMedDate not supplied

Optical coherence tomography imaging of surgical resolution of bilateral vitreomacular traction syndrome related to incomplete posterior vitreoschisis: a case report.

PURPOSE: To report a case of surgical resolution of bilateral vitreomacular traction syndrome related to incomplete posterior vitreoschisis as documented by optical coherence tomography (Stratus OCT, Carl Zeiss Meditec, Dublin, CA). CASE REPORT: In both eyes of a 72-year-old man with bilateral blurred vision, OCT examination disclosed a relevant increase in mean foveal thickness (right eye = 714 microm; left eye = 757 microm) due to a vitreomacular traction syndrome. At the edges of the most highly elevated area of vitreo-macular traction, OCT scans showed a characteristic splitting of the hyperreflective signal in both eyes, usually identified as posterior vitreous cortex. Both eyes underwent vitrectomy with epiretinal membrane peeling. Postoperative OCT examination showed vitreomacular traction resolution in both eyes with an evident decrease in mean foveal thickness (right eye = 364 microm; left eye = 335 microm). Right visual acuity improved from 20/200 to 20/50; left visual acuity changed from 20/150 to 20/40. CONCLUSIONS: OCT was a useful tool in identifying an unusual case of bilateral vitreomacular traction syndrome linked to incomplete posterior vitreoschisis and following a favorable course after surgical management.

Aged↗

PubMedDate not supplied

Optical coherence tomography and fundus microperimetry imaging of spontaneous closure of traumatic macular hole: a case report.

PURPOSE: To report a case of spontaneous closure of traumatic macular hole in a young patient followed using optical coherence tomography (OCT) and fundus microperimetry. METHODS/RESULTS: In the right eye of a 10-year-old child, a traumatic macular hole was observed to spontaneously resolve 18 weeks after blunt trauma. Initially, visual acuity in the right eye was 20/200 and OCT examination showed a 200 microm-diameter full-thickness macular hole with perifoveal edema. Fundus microperimetry examination showed an evident decrease in retinal sensitivity within the macular hole and in the upper macular region where an area of commotio retinae was clearly visible. During follow-up OCT demonstrated the appearance of a band of tissue linking the inferior edge of the hole to the foveal retinal pigment epithelium and at the bottom of the hole the presence of hyperreflective (glial) material. Eighteen weeks after trauma right eye visual acuity had improved to 20/25, OCT examination showed a restored foveal depression, and fundus microperimetry demonstrated an increase in foveal sensitivity. CONCLUSIONS: Both OCT and fundus microperimetry were useful tools for following the favorable course in a case of spontaneous closure of traumatic macular hole in a young patient. During follow-up OCT examinations were able to demonstrate the course of macular hole closure.

Child↗

PubMedDate not supplied

Custom measurement of retinal nerve fiber layer thickness using STRATUS OCT in normal eyes.

PURPOSE: To evaluate variability of retinal nerve fiber layer (RNFL) thickness measurements in normal eyes and their correlation with optic disc diameter by using two different scan options of the ultimate commercial optical coherence tomography (OCT) unit (STRATUS OCT, Carl Zeiss Meditec, Inc., Dublin, CA). METHODS: In this observational case series and instrument validation study 30 eyes of 30 normal subjects were enrolled. Each eye underwent optic disc vertical diameter measurement by means of both stereoscopic photography and planimetry and OCT; RNFL thickness measurements were performed using OCT. Three repetitions of two series of scans were performed. Each eye was scanned at two different options (RNFL thickness 3.4 and Nerve Head Circle). For each option descriptive statistics, analysis of variance, intraclass correlation coefficients (ICCs), and coefficients of variation (COVs) were calculated. To verify the correlation between the two methods of optic disc diameter assessment and to study the influence of optic disc diameter on RNFL measurement using the two different OCT options, Pearson's correlation coefficients were calculated. RESULTS: Optic disc diameter length ranged from 1.47 to 2.04 mm (mean 1.709 mm, SD +/- 0.147) with stereoscopic photographs, and from 1.47 to 2.02 mm (mean 1.703 mm, SD +/- 0.143) with OCT (Pearson correlation coefficient 0.999, p<0.001). Mean RNFL thickness was 89.29 mm (SD +/- 10.80 mm) using the RNFL thickness 3.4 scanning option and 89.88 mm (SD +/- 1.72 mm) using the Nerve Head Circle protocol (Pearson correlation coefficient 0.065, p=0.734). The intersubject variance is higher using the RNFL thickness 3.4 option than using the NHC protocol (sum of square: 1,014,760 vs. 25,741) (p<0.001); the intrasubject variance is very similar in the two groups (2,372 vs 2,360) (p=NS). The ICC is 99.89% when using the RNFL thickness 3.4 option, 95.62% with the NHC protocol (p=NS). COVs were 12.10% and 1.91% by using RNFL thickness 3.4 and Nerve Head Circle option, respectively. Pearson's correlation coefficient was 0.988 (p<0.001) when comparing optic disc diameter and RNFL thickness by using the RNFL thickness 3.4 option and -0.016 (p=0.932) when comparing optic disc diameter and RNFL thickness by using the Nerve Head Circle option. CONCLUSIONS: These results suggest that both scan options give good RNFL thickness measurement reproducibility; the use of the Nerve Head Circle option leads to less interindividual variability and can minimize the effect of differences in optic disc diameter on RNFL thickness measurements in normal subjects.

Adult↗

PubMedDate not supplied

Immunohistochemical findings in epiretinal membrane after long-term silicone oil tamponade: case report.

PURPOSE: To report pre- and post-operative macular optical coherence tomography (OCT) and immunohistochemical findings in a case of long-lasting silicone oil tamponade followed by silicone oil removal and epimacular membrane peeling. METHODS: A 69-year-old man with long-standing silicone oil tamponade and an epiretinal membrane at the posterior pole in his right eye (RE) underwent silicone oil/BSS exchange with epiretinal membrane peeling. Preoperatively, RE best-corrected visual acuity was 20/200 and macular OCT examination revealed a small increase in foveal thickness (250 microm) with the appearance of a linear hyper-reflective signal at the foveal vitreoretinal interface and a thicker (440 microm) hyperreflective finding causing posterior shadowing at the vitreoretinal interface inferiorly to the fovea. Histopathologic and immunohistochemical study of the specimen including the epiretinal membrane was performed. RESULTS: Light microscopy revealed extensive rounded empty spaces interpreted as silicone oil bubbles in the preretinal membrane. Macrophages marker (CD68) positive staining cells were found surrounding the empty spaces within the preretinal membrane and several empty spaces were observed intracellularly within macrophage cytoplasm. Thirty days after surgery best-corrected visual acuity was 20/60 and OCT examination showed an evident decrease in foveal thickness (220 microm) with the disappearance of any hyper-reflective signal at the vitreoretinal interface referable to an epiretinal membrane. CONCLUSIONS: The immunohistochemical study showed both silicone oil droplets and macrophagic cells embedded in the epiretinal membrane. Postoperative OCT demonstrated retinal recovery after silicone oil removal and epiretinal membrane peeling, thus justifying an unexpected visual acuity recovery despite the very long term tamponade.

Aged↗

PubMedDate not supplied

Prevalence of myopia in open angle glaucoma.

In this study concerning the prevalence of myopia in patients with open angle glaucoma, its distribution was analyzed within the sample tested in relation to the refraction defect size, compared with a control group of non-glaucomatous myopic subjects. The overall myopic rate was 17.2% of the glaucomatous patients; high myopia was more frequent in the subjects with open angle glaucoma (p less than 0.001) than in the myopic patients, thus appearing as a possible risk factor for the development of glaucoma.

Adult↗

PubMedDate not supplied

Effect of photorefractive keratectomy for myopia on measurement of retinal nerve fiber layer thickness using optical coherence tomography.

PURPOSE: To evaluate the effect of excimer laser photorefractive keratectomy (PRK) on nerve fiber layer thickness measurements by optical coherence tomography in myopic eyes. METHODS: Twenty-two patients who had PRK for myopia underwent nerve fiber layer measurement by optical coherence tomography in both eyes before and 6 months after surgery in the first operated eye and before surgery in the fellow (control) eye, 6 months after the first PRK. Optical coherence tomography was performed with a Humphrey Optical Coherence Tomography Scanner. Each eye was scanned at the nerve head program radius of 1.5. For each of the optical coherence tomography parameters (average for each quadrant, superior, inferior, temporal, nasal; average for each clock hour; average over the entire cylindrical section), descriptive statistics were calculated. The difference between the observed change from the first to the second examination was calculated between the treated and the control eye. Individual mean differences were tested with Student's t-test. Hotelling's T-squared generalized means test was used to determine whether the set of mean differences was equal to zero. RESULTS: The average preoperative refractive error was -3.90+/-1.50 D in treated eyes and -3.89+/-1.50 D in control eyes (P = .81, Student's t-test). Mean achieved refractive correction was 3.70+/-1.70 D, corresponding to 48.1+/-22.1 microm of corneal ablation. No statistically significant difference was found in any measurement in the treated eye compared with the untreated control eye. CONCLUSIONS: At 6 months postoperatively, photorefractive keratectomy for moderate myopia that resulted in clear corneas did not affect nerve fiber layer thickness measurements, as obtained by optical coherence tomography.

Adult↗

PubMedDate not supplied

[Work and education].

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Education, Nursing↗