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Biomedical subjects

M Stirpe

Publications and source records attributed to M Stirpe.

At least 19 recordsLinked to original sources
PubMed2001

Evaluation of primary surgical procedures for retinal detachment with macular hole in highly myopic eyes: a comparison [corrected] of vitrectomy versus posterior episcleral buckling surgery.

PURPOSE: To evaluate postoperative outcomes between pars plana vitrectomy (PPV) and posterior episcleral buckle procedure (PEBP) in myopic eyes with retinal detachment (RD) and macular hole (MH). DESIGN: Retrospective nonrandomized comparative interventional trial. PARTICIPANTS AND INTERVENTION: The study included 30 phakic, highly myopic eyes (from 19-30 negative diopters) of 30 patients with an RD and MH. The patients were divided into two groups: They were assigned to PPV (15 eyes, group A) or to PEBP (15 eyes, group B). No significant (P > 0.01) differences in preoperative visual acuity (VA) between group A and group B eyes were found. Follow-up was 12 months. MAIN OUTCOME MEASURES: Anatomic attachment of the retina was determined, and VA was measured. RESULTS: Retinal reattachment was obtained on 11 of 15 (73.3%) eyes of group A and on 14 of 15 (93.3%) eyes of group B. In group A eyes the VA was substantially unmodified after surgical treatment, whereas in group B eyes the VA observed after surgical treatment increased significantly (P < 0.001) with respect to the preoperative values. CONCLUSIONS: PEBP resulted in better postoperative anatomic and functional results compared with PPV in eyes with extreme degrees of myopia, pronounced posterior staphyloma, and posterior vitreous schisis affected with RD caused by MH.

Adult↗
PubMed2001

Multiple lipomas linked to an RB1 gene mutation in a large pedigree with low penetrance retinoblastoma.

Hereditary predisposition to lipomas is observed in familial multiple lipomatosis (OMIM 151900) and benign cervical lipomatosis (OMIM 151800) and can also be associated with mutations in the MEN1 and PTEN genes (OMIM 131100 and 153480, respectively). In addition, a recent report indicates that a few patients with hereditary retinoblastoma also have lipomas. Here we report on an extended family segregating a splice site mutation in the RB1 gene. Almost all adult carriers of this mutation had multiple lipomas while penetrance for retinoblastoma was incomplete. In an unrelated pedigree, which was reported previously, the identical mutation was only associated with low-penetrance retinoblastoma but not lipomas. Our data indicate that lipoma predisposition in hereditary retinoblastoma is not associated with specific RB1 gene mutations but is influenced by modifying factors linked to this gene.

Base Sequence↗
PubMed1998

Optical coherence tomography.

The optical coherence tomograph is a new, noninvasive technical device that can obtain cross-sectional, high-resolution images-optical coherence tomographs (OCT)-of the retina. This instrument permits an accurate evaluation of various macular and chorioretinal pathologies and the early detection of glaucomatous damage. Images of the retina are obtained similar to ultrasound B-scan, with 10-microm longitudinal resolution. Because the OCT operates with a near-infrared wavelength (about 840 nm), the examination is of minimal discomfort for the patient. OCT examination is indicated in cases of macular pathologies such as vitreoretinal interface syndrome, in the early detection and quantitative assessment of macular edema, and in the evaluation of a glaucomatous damage by measuring the retinal nerve fiber layer thickness. The future role of this instrument and its applications for clinical diagnosis depend on the future improvement and updating of the software.

Humans↗
PubMed1997

Pars plana vitrectomy for retinal detachment due to internal posterior ophthalmomyiasis after cataract extraction.

BACKGROUND: The authors report a case of posterior internal ophthalmomyiasis causing vitreous haemorrhage and retinal detachment after uncomplicated cataract extraction. CASE REPORT: The patient suffered an abrupt vitreous haemorrhage 9 days after ECCE and posterior chamber IOL implantation. After 2 months the haemorrhage did not clear up and a retinal detachment arose. The patient underwent encircling scleral buckle, pars plana vitrectomy and fluid-gas exchange. In course of intervention the surgeon removed from the vitreous chamber a 14-mm-long round worm subsequently identified as a dipterous larva of the Sarcophagidae family. DISCUSSION: The patient showed no sign of subretinal tracking or retinal breaks or holes. The sclerocorneal surgical wound seems the most likely site of entrance of the parasite, and this would then be the first reported case of myiasis with no RPE tracking.

Aged↗
PubMed1997

The use of panoramic viewing system in relaxing retinotomy and retinectomy.

BACKGROUND: Retinotomies and retinectomies are surgical procedures mainly devoted to the peripheral retina that require optimal visibility and adequate magnification to make the surgeon's task easy, quick, and safe. The purpose of present study was to estimate to what extent the introduction of wide-angle viewing systems can help the surgeon perform safer and more effective retinotomy procedures. MATERIALS AND METHODS: The authors retrospectively analyzed the records of patients undergoing retinotomy procedures between 1993 and 1995 and divided them into two groups according to the viewing system used during the retinotomy procedures. Group 1 included 86 eyes that underwent surgery between July 1991 and June 1993 with Lander's plano-concave and prismatic lenses (Optikon, Rome, Italy), and group 2 included 96 eyes that underwent surgery between July 1993 and June 1995 with the Advanced Vitreoretinal Instruments system (New York, NY). Outcome measures were divided into preoperative (diagnosis at baseline, anterior proliferative vitreoretinopathy grade and extension, and visual acuity), intraoperative (size of retinotomy, number of laser spots, need for scleral depression, lensectomy, intraocular lens and capsule removal, and duration of treatment) and postoperative (anatomic success rates, visual acuity, postoperative intraocular pressure, and need for postoperative laser treatment and follow-up treatment). RESULTS: Among preoperative parameters, there were no significant differences between the two groups. For intraoperative parameters, eyes in group 2 underwent significantly shorter surgical procedures, had less of a need for scleral depression, and, as a group, had a higher average number of laser spots. For postoperative parameters, eyes in group 2 had a significantly lower need for laser treatment at the edge of retinotomy after surgery. CONCLUSION: Our results suggest that the use of a panoramic viewing system significantly decreases the time required for intervention, allowing more complete laser treatment along the edge of the retinotomy and lowering the need for scleral depression. The need for completion of laser treatment along the edge of the retinotomy after surgery also is reduced significantly, possibly increasing patient comfort because, especially in the early postoperative days, postoperative laser treatment can be extremely uncomfortable for the patient and difficult to perform for the surgeon. No prognostic benefit has been proven for any of the two groups because anatomic and visual results were overlapped.

Follow-Up Studies↗
PubMed1997

Scanning laser ophthalmoscopy in the early diagnosis of vitreoretinal interface syndrome.

BACKGROUND: The purpose of this study was to estimate if and to what extent scanning laser ophthalmoscopy can help in the early diagnosis and follow-up management of the vitreoretinal interface syndrome, which includes disorders such as cellophane maculopathy, pseudomacular hole, macular pucker, and macular hole. METHODS: The 35 fellow eyes of 35 patients with vitreoretinal interface syndromes in the first eye underwent scanning laser ophthalmoscopy microperimetry and argon, helium-neon, and infrared scanning laser ophthalmoscopy. Fellow eyes were defined as clinically positive or negative for vitreoretinal interface syndrome. Fellow eyes then were classified based on scanning laser ophthalmoscopy techniques. Patients were observed for an average of 18 months (range, 10-26 months). RESULTS: Thirty-two of the 35 fellow eyes were classified as clinically negative, and three of the 35 were classified as clinically positive. Fifteen of the 32 clinically negative fellow eyes were redefined as positive on scanning laser ophthalmoscopy. None of the clinically positive eyes proved to be negative on scanning laser ophthalmoscopy. During the average follow-up period (18 months), the condition of five of 18 fellow eyes that were positive on scanning laser ophthalmoscopy worsened. None of the 17 eyes that were negative on scanning laser ophthalmoscopy worsened. CONCLUSION: Scanning laser ophthalmoscopy can produce beautifully clear images of structures that are otherwise difficult to see and document, such as posterior hyaloid and the inner retinal layers. Despite a relatively limited number of cases and the short duration of the follow-up period, the present study suggests that scanning laser ophthalmoscopy has good sensitivity and specificity for the early diagnosis of vitreoretinal interface syndromes.

Eye Diseases↗
PubMed1996

Retinal detachment after clear lens extraction in 41 eyes with high axial myopia.

PURPOSE: Clear lens extraction is a surgical procedure to correct high axial myopia. The authors explain how this technique may lead to serious vitreoretinal complications. METHODS: The study included 41 eyes of 39 patients aged 25 to 58 years (mean, 37.5 years) with high axial myopia (14-29 diopters; mean, 19.5 diopters) operated on for retinal detachment after clear lens extraction. Retinal detachment occurred 1 month to 4 years after lens extraction, except for two eyes that also had intraoperative choroidal hemorrhages. RESULTS: Twenty-six of the 41 eyes had undergone 360 degree prophylactic retinopexy on preequatorial areas; in four eyes, the retinal breaks occurred along the edge of the prior circumferential photocoagulation. Seventeen eyes exhibited proliferative vitreoretinopathy of various grades. The retina was reattached in 36 eyes. Only nine eyes achieved final visual acuity of 20/60 or better. CONCLUSIONS: Although the authors do not report the actual incidence of retinal detachment after clear lens extraction, they indicate that potentially blinding complications can occur after this surgical procedure, despite prophylactic treatments.

Adult↗
PubMed1995

Analgesic effect of topical diclofenac versus betamethasone after posterior segment surgery.

BACKGROUND: In clinical use, topical diclofenac, a nonsteroidal antiinflammatory, was found to be remarkably effective as an analgesic. A trial was therefore conducted to quantify and compare this effect with that of other drugs commonly used after posterior segment surgery. METHODS: A single-blind, randomized study of 37 patients undergoing posterior segment surgery was conducted. On the day of surgery and for 30 days thereafter, one group received topical diclofenac 0.1% and one group received topical betamethasone 0.1%. Pain intensity was assessed by two standard psychologic tests, the McGill Pain Questionnaire (MPQ) and Scott's Visual Analogic Scale (VAS). RESULTS: The group receiving diclofenac had significantly lower pain scores on the MPQ at days 1 and 15 (P < 0.05 and P < 0.03, respectively). The VAS scores were also statistically lower for this group on day 15 (P < 0.03). CONCLUSION: Topical diclofenac 0.1% has greater analgesic action than topical betamethasone 0.1% without the side effects of steroids, and may be useful after posterior segment surgery.

Administration, Topical↗
PubMed1994

Surgical avulsion of the iris to treat selected cases of neovascular glaucoma.

Surgical avulsion of the iris was performed in 11 eyes of 11 patients affected with diabetic retinopathy, rubeosis of the iris and neovascular glaucoma that had been unsuccessfully treated otherwise. Nine eyes had extensive iris neovascularization, complicated cataract and vitreous haemorrhage, whereas the other two eyes were aphakic and had previously undergone vitrectomy, lensectomy and extensive laser photocoagulation. Prior to surgical avulsion of the iris, all eyes received topical and entheric hypotensive therapy. The intraocular pressure (IOP) ranged from 24 to 52 mmHg. Iris avulsion lowered the IOP in 9 of the 11 eyes treated (IOP range, 6-19 mmHg).

Adult↗
PubMed1990

Retinal detachment in highly myopic eyes due to macular holes and epiretinal traction.

We operated on four highly myopic eyes with recurrent retinal detachment due to macular holes. A thin layer of epiretinal tissue was present over the posterior retina in each eye, probably causing tangential traction on the retina and accounting for the recurrent detachment. Biopsy of the tissue from one case showed mainly acellular material resembling cortical vitreous. Recognizing this clinical condition may permit successful treatment of certain cases with recurrent retinal detachment in highly myopic eyes with macular holes.

Adult↗
PubMed1987

Vitrectomy, scleral buckling, and peripheral diathermy treatment for severe proliferative vitreoretinopathy.

Transvitreal diathermy was combined with vitrectomy, scleral buckling, and silicone oil injection to treat 28 eyes with severe proliferative vitreoretinopathy and fore-shortened peripheral retina. A special gold tip on the diathermy probe prevented adhesions to the retina. The probe can be used for coaxial bipolar diathermy or for internal-external bipolar diathermy when combined with an electrode on the external scleral surface. Nineteen (68%) of 28 eyes treated with these methods achieved anatomic success and 10 eyes obtained final visual acuity ranging from 5/200 to 20/70.

Combined Modality Therapy↗
PubMed1978

[On the prophylactic treatment in retinal detachment (author's transl)].

Within a period of three years, 152 eyes in 149 patients underwent prophylactic treatment for retinal lesions. The elements are considered that would move the surgeon to propose to the patient a prophylactic treatment. No complications were found in any of the eyes that were treated, however a retinal detachment occurred in two eyes, 6 to 8 months after treatment. Retinal lesions treated by prophylactic means are compared with those found in 500 eyes operated for retinal detachment during the same period. The results of this study leads to the conclusion that a real risk of retinal detachment is more dangerous than the possible consequences of prophylactic treatment.

Adolescent↗