Biomedical subjects

U Menchini

Publications and source records attributed to U Menchini.

At least 37 records · Page 2Linked to original sources

PubMed1993

Cystoid macular oedema after extracapsular cataract extraction and intraocular lens implantation in diabetic patients without retinopathy.

Postoperative onset or aggravation of cystoid macular oedema (CMO) in diabetic patients after extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation is a frequent problem. At present little is known about the occurrence and prognosis of this complication in diabetics with no clinically detectable diabetic retinopathy (DR). Twenty five diabetic eyes (24 subjects) without DR and 45 normal eyes (44 subjects) were studied before surgery and 30, 90, 180, 360 days after ECCE and posterior chamber IOL implantation. Fluorescein angiography was performed at each examination. The frequency of angiographic CMO in the two groups was comparable 30 days after surgery but was significantly higher in diabetic eyes at 90, 180, and 360 days. This finding is probably related to an impairment of the blood-retinal barrier in diabetics. Final visual acuity, however, was similar in the two groups.

Aged↗

PubMed1992

Can the diode laser (810 nm) effectively produce chorioretinal adhesion?

In this study, argon green (514 nm), krypton red (647 nm), and diode (810 nm) lasers were used to produce transpupillary photocoagulations on rabbit chorioretina to simulate a retinal buckle treatment. To evaluate the efficacy of the diode laser in creating a retinopexy effect, the morphologic aspects of the acute lesions and scar development were compared. The study of the acute lesions revealed that the chorioretinal thermal damage produced by the argon green laser involved all the retinal layers and the retinal pigment epithelium. The use of the krypton red and the diode lasers resulted in deeper chorioretinal thermal damage. Two months after the treatments, all the lesions resulted in adhesive chorioretinal pigmented scars. However, the diode lesions produced a deeper scar, characterized by marked chorioretinal atrophy.

Animals↗

PubMed1991

Unilateral proliferative diabetic retinopathy and uveitis in the fellow eye: report of a case.

We report the case of a young man with a 20-year history of insulin-dependent diabetes mellitus, proliferative diabetic retinopathy OD, and uveitis OS. None of the common reported causes contributing to this difference between eyes was present. No features of diabetic retinopathy appeared OS after a follow-up of 36 months. This is the first case, to our knowledge, in which uveitis appeared to be associated with an asymmetric presentation in diabetes.

Adult↗

PubMed1991

Combined vitrectomy, cataract extraction, and posterior chamber intraocular lens implantation in diabetic patients.

Combined extracapsular cataract extraction, pars plana vitrectomy, and posterior chamber intraocular lens implantation was performed in six eyes with proliferative diabetic retinopathy. These eyes all had minimal iris vascular changes and were at reasonably low risk for developing intraoperative and postoperative complications. The surgery must be relatively brief and the endophotocoagulation accurate. Initial visual acuities ranged from light perception to 4/200. With an average follow-up of 9.7 months, final acuities ranged from 4/200 to 20/40.

Aged↗

PubMed1990

Argon versus krypton panretinal photocoagulation side effects on the anterior segment.

The modification of corneal sensitivity, accommodation, pupillary diameter and endothelial cell density after argon versus krypton panretinal photocoagulation were studied prospectively in 88 eyes of 64 diabetic patients with proliferative diabetic retinopathy, randomized for one of the two laser treatments. In both groups a marked internal ophthalmoplegia and reduction of corneal sensitivity occurred after laser photocoagulation. At no time, 2, 90 and 180 days after PRP, were these parameters significantly different. Endothelial cell loss was non significantly greater in the krypton group. The results indicated that the side effects commonly observed on the anterior segment after PRP are comparable using argon or krypton lasers.

Accommodation, Ocular↗

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↗

PubMed1990

[Iris vascular anomalies: angiographic aspects].

The authors report five cases of abnormal iris vessels observed in patients, without evident local or systemic pathology. These vessels, are dilated channels. On iris fluorescein angiography their filling appeared earlier than in normal stromal vasculature and was synchronous with that of conjunctival vessels. No dye leakage was present. Two functional angiographic pictures are observable: 1) vessels with abnormal diameter and path, approximately following normal iris vessel arrangement (case 1 and 2); 2) atypical vessels with wide communicating shunt between artery and vein without collaterals (cases 3, 4 and 5). These vessels are very tortuous and do not show any abnormality. The authors suggest to consider these anomalous vessels as anatomic abnormalities comparable with the arterio-venous communications of the retina.

Aged↗

PubMed1989

Prevalence of retinopathy in diabetic subjects from out-patient clinics in Lombardy (Italy), and associated risk factors. A multicentre epidemiologic study.

There is little information on the prevalence of diabetic complications in Italy. For this reason, a multicentre population-based study was carried out in 1983-1985 in 12 representative out-patient clinics for the treatment of diabetes in the Lombardy region. Out of a total population of 17,704 patients 1160 diabetic subjects were randomly selected within strata based on their duration of disease (less than or equal to 5; 6-10; 11-20; greater than 20 years). Eight hundred and thirty-eight responders were examined using standardised protocols. The estimated prevalences (adjusted for duration of disease) for the total population involved in the study were 29.7% and 7.6% for background and proliferative retinopathy respectively. The overall standardised rates were higher in insulin-dependent diabetes mellitus (IDDM) (53.6%) than in non-insulin-dependent diabetes mellitus (NIDDM) (34.7%) for both background (41.1%, 28.4% respectively) and proliferative (12.5%, 6.2% respectively) retinopathy, and increased with the duration of disease. The analysis of the relationship between diabetic retinopathy and the calculated risk factors did not show any association with hypertension or metabolic control, except for post-prandial blood glucose in subjects with durations 6-10 and greater than 20 years; an association with azotaemia was found in subjects with durations less than or equal to 5 and 11-20 years. Diabetic retinopathy appeared to be independently associated with the type of treatment and not with the type of diabetes, metabolic control, or hypertension.

Diabetic Retinopathy↗

PubMed1989

Clinical evaluation of the effect of acetylcholine on the corneal endothelium.

A transient corneal edema is often seen after the injection of acetylcholine solution in the anterior chamber during cataract surgery. Ninety eyes of 90 patients scheduled for extracapsular cataract extraction with posterior chamber intraocular lens implantation were randomly assigned to two groups: one which received acetylcholine solution in the anterior chamber and one, a control group, which received only external conjunctival pilocarpine drops as a miotic. At three days, endothelial folds (P = .04) and corneal edema (P = .01) were more pronounced in the acetylcholine group; at seven days, endothelial folds were more severe (P = .04) in the acetylcholine group. At 30 days, the acetylcholine group showed a 37.2% increase (P = .01) of the endothelial cell area, whereas the control group showed a 7.08% increase. The difference between the groups was statistically significant (P = .05). Anterior chamber fluorophotometry at 30 days showed an increase of the corneal transfer coefficient that was higher but not significant in the acetylcholine group. We suggest caution in the intraoperative use of acetylcholine solution, particularly in those eyes showing a preoperative compromise of the endothelium.

Acetylcholine↗

PubMed1988

Bullous retinal detachment in diffuse retinal pigment epitheliopathy.

Central serous choroidopathy can occur in an atypical, severe clinical expression also known as diffuse retinal pigment epitheliopathy. We report two cases in which this affection was complicated by a bullous retinal detachment of the lower quadrants. In one case the subretinal leaking point was photocoagulated. The evolution was favourable in both cases with resolution of the detachment and partial recovery of the visual acuity.

Adult↗

PubMed1988

Dye laser photocoagulation of macular subretinal neovascularization in pathological myopia. A randomized study of three different wavelengths.

The authors present a randomized study of 27 eyes affected by pathological myopia with macular subretinal neovascularization which were treated with a tunable dye laser. The effectiveness of three different wavelengths (577, 590 and 620 nm) in the direct treatment of subretinal neovascularizations was evaluated in 3 groups of 9 patients each. Statistical analysis of both visual and anatomical results did not show significant differences among the three wavelengths used.

Adult↗

PubMed1988

Pneumoretinopexy in the treatment of retinal detachment with macular hole.

Nine eyes of nine patients affected by retinal detachment with macular hole were treated with pneumoretinopexy and postoperative positioning. All the eyes were myopic (mean 13.3 d., sd 3.3), two were amblyopic and one was aphakic. The operative technique included eye softening and intravitreal SF6 gas injection only. Barrage laser photocoagulation was carried out after retinal reattachment. In seven eyes (77.8%) the retina reattached in a mean of three days and the visual acuity improved. No recurrences were observed after a mean of 11.6 months. No severe complications occurred. Vitreous flare was present in 44% and increase of floaters in 55% of the eyes. We believe that pneumoretinopexy can be employed as the first treatment in case of myopic retinal detachment with macular hole.

Aged↗

PubMed1988

Frequency of blood-retina and blood-brain barrier changes in multiple sclerosis.

The frequency of blood-retina barrier (BRB) and blood-brain barrier (BBB) alterations was studied in 20 cases of Multiple Sclerosis (MS) (12 relapsing and 8 chronic-progressive). BBB impairment was found in 7 out of 20 patients (35%), 3 of whom had the chronic-progressive form of the disease. Alterations to BRB were found in 9 out 20 cases (45%): 2 out 12 (17%) of the relapsing cases and 7 out 8 of the chronic-progressive cases (87.5%). BBB impairment was found in 3 of the 9 cases (33%) with BRB alterations. Our findings indicate that BRB and BBB alterations do not occur simultaneously. We propose that the higher frequency of BRB alterations in chronic-progressive MS may be a sign of persistent antigenic stimulation.

Blood-Brain Barrier↗

PubMed1988

Retinal laser photocoagulation in diabetic patients causes prolactin, growth hormone and cortisol release.

Stress of many kinds (psychological, physical, metabolic) is able to induce endocrine modifications in humans, such as growth hormone (GH), prolactin (PRL), luteinizing hormone (LH), glucagon and cortisol release. Argon laser photocoagulation of the retina (RP), the treatment of choice for diabetic retinopathy, is a painful and stressful maneuvre and represents a direct injury onto a nervous tissue. Therefore it was decided to evaluate the possible endocrine modifications induced by RP in diabetic patients affected by retinopathy. In 19 insulin-dependent diabetic patients (12 men and 7 women), RP induced cortisol release in all cases, GH and PRL release in men, but not in women, and no modification of LH and glucagon plasma levels; in 12 similar patients receiving saline infusions without RP, no endocrine modifications were observed. It is concluded that RP elicits GH, PRL and cortisol release in diabetic patients.

Adult↗

PubMed1988

Complications of argon laser retinal buckling performed in myopic subjects presenting rhegmatogenous degenerations.

Twenty-two eyes of twenty-two patients suffering from retinal peripheral degenerations underwent preventive equatorial buckling with argon laser photocoagulation. The fellow eye was used as control. We evaluated the effects of laser photocoagulation on corneal sensitivity, on accommodation, on pupillary diameter and light reflex. In the postoperative period, up to the 3rd month, results were significant with respect to the control eye. The mechanisms to which the onset of these undesired alterations is due are discussed.

Accommodation, Ocular↗

PubMed1988

Enucleation after argon laser photocoagulation for choroidal melanoma.

We report the case of a choroidal melanoma 3 disc-diameter in size and 1 mm in thickness located superiorly at 2 disc-diameters from the optic disc. Argon laser photocoagulation was done in 1977. No recurrence was observed for eight years. In 1985, the melanoma suddenly reappeared, invading the posterior pole and causing secondary retinal detachment. The histologic examination after enucleation revealed a spindle-cell melanoma. Considering the fluorescein angiographic findings, we question the effectiveness of argon laser photocoagulation of choroidal melanoma.

Argon↗

PubMed1988

[Fluoroiridographic aspects of iridoschisis].

Iridoschisis is a rare condition of uncertain etiology characterized by a cleavage of the iris layers. We report four cases studied by fluorescein angiography to display possible occurrence of vascular abnormalities in the pathogenesis of the disease. Case 1: 80 year old woman with bilateral schisis of the peripheral iris, in the inferonasal quadrant in RE and inferotemporal in LE. A shallow anterior chamber was present in OU; IOP was 18 in RE and 15 in LE. No corneal abnormalities were present. Fluoroiridography showed a normal pattern filling of the iris vascularity, that was more visible in the schisis area. Case 2: 66 year old man with diabetes and open-angle glaucoma operated on for trabeculectomy five years previously. The examination showed a normal cornea, a shallow anterior chamber and miotic pupils for pilocarpine therapy. IOP was 12 in OU. The iridoschisis was present in RE in the lower sectors which were totally involved from the outer iris to the inner pupillary margin. Fluoroiridography indicated a normal vessel perfusion without any abnormality in the affected sectors. A slight bilateral pupillary dye leakage without any stromal diffusion was attributable to the patient's age. Case 3: 55 year old woman treated with miotics in RE for a glaucoma diagnosed after head trauma twenty years before, after which the vision in LE was reduced to 2/200 for post-traumatic optic nerve atrophy. No corneal abnormality was present. The anterior chamber was shallow and the ocular tension was 14 in RE and 10 in LE.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1987

Laser treatment of macular subretinal neovascularizations in angioid streaks.

A serous hemorrhagic maculopathy with a subretinal neovascular membrane appears in about 70% of cases of angioid streaks. In this study a series of 60 eyes (31 patients) was reviewed. In 13 eyes macular subretinal neovascularizations were photocoagulated with blue-green argon laser, green argon laser, dye laser (rhodamine 6G) at 590 nm and red krypton laser. The authors present and discuss the results obtained and suggest that photocoagulation of subretinal new vessels not involving the fovea can be worth performing.

Adolescent↗