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Dyslexia is a language-based learning disability. Although this condition is characterized by anatomical malformation of the brain, it seems that the typical reading pattern of dyslexic may be also related to more complex sensory deficits. Among them, visual-perceptive deficits have been described in a subtype of dyslexia, called visual-perceptive dyslexia. The distinctive feature of a patient suffering from visual-perceptive dyslexia form is marked by effortlessly recognize the characteristics of each individual stimulus. The Tetra protocol is a visual-perceptual evaluation protocol that was introduced for the diagnostic phase and the rehabilitation of visual-perceptive dyslexia. The diagnostic tests include: the eidomorphometry test, designed to evaluate the perception of spatial relationships; the contrast sensitivity threshold test, especially at low spatial frequencies; and the REPORT TEST words, to assess the speed and the reading efficiency. In addition, the rehabilitation phase is carried out with the visual neuro-enhancement program TRIGRAM, a visual training proposal designed to reduce the lateral masking phenomenon in visual-perceptive dyslexic. Thus, in this study we used the diagnostic tests of TETRA® Protocol to determine presence of visual-perceptual abnormalities in children with dyslexia. Proven time the presence of these visual-perceptual alterations, the patients were also subjected to the rehabilitation sessions of TRIGRAM, in order to investigate whether this visual training may improve the pattern of reading. At the end of the program (t1) and after three months (t2), the same subjects underwent the same diagnostic tests of TETRA® Protocol to evaluate and confirm the results obtained during rehabilitation program. The results showed a significant increase in contrast sensitivity at low and high spatial frequencies. Moreover, the same improvements in the visual system's ability to discriminate the contours of an object within the field of view, have been maintained three months after the end of treatment. We also observed a significant improvement in the perception of spatial relationships, with reduction of SRA value. In conclusion, this study demonstrates that the visual rehabilitation training (TRIGRAM) is able to improve the perception of spatial relationships, and increase contrast sensitivity in young patients affected by "visual dyslexia". Nonetheless, these data need to be confirmed in larger cohort of subjects in order to establish whether these effects can also increase lexical ability (increased reading speed and reduce errors during the lexical task).

Purpose: To evaluate the efficacy and the safety of the enzymatic vitreolysis with a single intravitreal injection of ocriplasmin 125 μg across a group of patients with symptomatic vitreomacular adhesion (sVMA) during 6 months follow up. Design: A randomized, placebo-controlled, double-masked, 6-month follow up study. Participants: A total of 28 patients (12 M / 16F) (19 receiving ocriplasmin; 9 receiving placebo), mean aged 71 years old, diagnosed with sVMA, VMT, FTMH e ERM by optical coherence tomography. Methods: A single intravitreal injection of ocriplasmin 125 μg or placebo. Primary endpoint was sVMA resolution or FTMH closure. Secondary endpoint included the integrity of the external membrane and the inner and outer segments of the photoreceptor interface using OCT. The evaluation was carried out at baseline and during 6 months after intravitreal injection of ocriplasmin or placebo. Results: After a 6 months follow-up period, the rate of VMA resolution was 42.1% in the Ocriplasmin group vs the 22% in the placebo group. FTMH closure rate was 50% in the Ocriplasmin group vs 0% in the placebo group. The best results were optained within 28 days from the treatment. No case of uveitis, endophthalmitis, retinal tears, retinal detachment or bleeding during follow-up were reported. One patient reported floaters and transitional photopsias. Conclusions: The study confirmed the efficacy and safety of Ocriplasmin injection for patients with VMT, including when associated with full-thickness macular holes during six months follow up. Long term studies are certainly needed to confirm these results.

Background: Retinal arterial macroaneurysms (RAM) is a pathological dilatation of retinal arterial vessel. Argon laser photocoagulation has been for a long time the gold standard of many vascular diseases of the retina such as macroaneurysm. From this work emerges how the introduction of intravitreal anti-VEGF therapies have enhanced the 'effectiveness of the combination of argon laser photocoagulation in cases of persistent retinal edema, we present the case of a retinal macroaneurysm with macular hemorrhage focus and oedema in a patient with a history of systemic arterial hypertension. Methods: A 77 year-old woman patient reported sudden decline in visual acuity in the left eye; the best corrected visual acuity (BCVA)was 1/10 in left eye. Fluorescein angiography (FAG) resulted in diagnosis of Macroaneurysm at the posterior pole with macular hemorrhage focus and oedema. The patient was treated with laser treatment in the left eye; after 30 days, the visual acuity was 1/50 and at optical coherence tomography (OCT) the retinal profile was significantly altered. After 30 days, a single intravitreal ranibizumab injection was performed and, after 7 days, visual acuity was 1/10. After 24 months from ranibizumab-based therapy the final visual acuity was 10/10 and OCT examination revealed a normal retinal profile. Conclusion: In this case report the association of argon laser photocoagulation with intravitreal anti-VEGF injection has been proven to be effective and safe in case of persistent retinal oedema.

Objective: The study compares the effectiveness of an intravitreal slow-release dexamethasone implant respect to an intravitreal injection of a anti-VEGF, ranibizumab, in the treatment of diabetic macular edema (DME). Design: we used a non randomized retrospective study to compare the effectiveness of two treatment approaches to DME Subjects: 50 patients were investigated, 30 of whom underwent injections of ranibizumab and 20 of whom underwent dexamethasone implantation. Methods: When patients were injected with the anti-VEGF ranibizumab, they were monitored every three months. Dexamethasone implant was administered only once in 6 months, different to ranibizumab which was administered monthly . Main Outcome Measures: these were carried out by measuring the improvements in ETDRS (visual acuity scores) and CMT (central macular thickness) after one month, three months, and six months (T1, T3, T6). intraocular pressure were performed. Results: Data evidenced that the slow-release dexamethasone implant is more efficacious than the intravitreal injection of the anti-VEGF, ranibizumab, in terms of improvement of visual acuity and central macular thickness. Dexamethasone implant at T3 produced an improvement of visual acuity which was significantly better respect to injections of ranibizumab, with a mean ETDRS gain of nearly 8,5 letters, compared to only 4 letters gained in the case of ranibizumab injected patients. This significance, however, is lost by T6, (p=0.516), where those treated with dexamethasone had lost 6 of the eight letters gained, while those with ranibizumab had lost 4 letters. As such, the overall gain at the T6 checkpoint was only 2.5 letters for dexamethasone implant and 2 for ranibizumab. Conclusion: The study highlighted a better initial efficacy of the dexamethasone implant due to its superior performance at 3 and 6 month evaluation points.

Purpose: to evaluate the efficacy and safety of combined therapy with Photodynamic Therapy with Verteporfin (PDT-V) and intravitreal ranibizumab same-day compared with monotherapy with ranibizumab (three monthly injections ) for the treatment of the choroidal neovascularization (CNV) due to age-related macular degeneration (AMD). Type of study : open-label, randomized controlled trial (RCT). Materials and Methods: 17 eyes of 17 patients were consecutively enrolled and randomly assigned to ranibizumab intravitreal injection + PDT compared with a control group of 30 eyes of 30 patients treated with only ranibizumab 0.5mg in three monthly injections. Best corrected visual acuity (BCVA), central macular thickness (CMT) on optical coherence tomography were examined before and after treatment. Patients were followed-up for twelve months. Results: in the combined therapy group, the mean baseline BCVA is 32.6 letters, at 24-months after treatment it’s 31.4 letters with a loss of 1.2 letters. The mean central thickness at baseline is 314.6 µm. After twenty four months the mean CMT is 222.5 µm, with mean CMT reduction of 92.1µm. In the ranibizumab-alone group, the mean baseline BCVA is 29.1 letters at 24-months it’s 28.6 letters with a little loss of 0.5 letters. The mean baseline CMT is 297.6 µm, at 24-months it is 235.9 µm, with mean CMT reduction of 61,7µm. Conclusions: the two treatments showed the same efficacy from a functional and anatomic point of view with a less number of retreatments in the combined therapy group. There were no serious ocular adverse events such as retinal detachment, endophthalmitis or ocular hypertone.

Background: The aim of this study is systematically review the scientific literature on the relationship between tobacco smoking exposure and UM. Methods: The search was performed on Medline and Scopus databases. For each database, we used the following query: “smok* AND (eye OR uveal) melanoma”. Results: 3 observational studies were considered suitable, two case-control studies and one cohort study. There is no significant evidence in the scientific literature about the association between smoking and UM. Conclusions: More complete and multi-center studies are desirable, giving the importance of smoking as a risk factor in the development of cancers.

Introduction: Accomodative esotropia is secondary to inappropriate convergence during accomodative effort in an uncorrected hyperope and is often familial. Case presentation: we report the case of 20 year old Caucasian patient with congenital esotropia alternating, of 30 prism diopters distance (5 m) and 40 prism diopters of esotropia at near, in both eyes. Measures: Was performed strabismus, in peribulbar anesthesia, the right medial rectus was cashed 3.0mm, the left medial rectus was collected 3.5 mm. Results: Immediately after surgery, the patient complained of intermittent diplopia, resolved with orthotic exercise which stimulated binocular vision, Conclusion: This case report suggests that the surgical correction strabismus, should be considered with due caution in the treatment of congenital esotropia alternating and branches, and in some clinical scenarios selected to avoid the complication of postoperative diplopia, that in the case report resolved so benign. After three months surgical treatmen, remains a small angle strabismus aesthetically acceptable, has not given double vision and remains abnormal retinal correspondence with orthotic exercise.