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102. Optical coherence tomography angiography assessment of vascular effects occurring after Aflibercept intravitreal injections in treatment-naive patients with wet AMD

Author

Mastropasqua, Leonardo, Toto, Lisa, Borrelli, Enrico, Carpineto, Paolo, Di Antonio, Luca, and Mastropasqua, Rodolfo

Subjects
retinal vasculature, intravitreal aflibercept injections, choroidal vasculature, Type 1 choroidal neovascularization, treatment-naive exudative age-related macular degeneration, patients
Published
2017

103. Vascular changes after vitrectomy for rhegmatogenous retinal detachment: optical coherence tomography angiography study.

Author

Bonfiglio, Vincenza, Ortisi, Elina, Scollo, Davide, Reibaldi, Michele, Russo, Andrea, Pizzo, Alessandra, Faro, Giuseppe, Macchi, Iacopo, Fallico, Matteo, Toro, Mario D., Rejdak, Robert, Nowomiejska, Katarzyna, Toto, Lisa, Rinaldi, Michele, Cillino, Salvatore, Avitabile, Teresio, and Longo, Antonio

Subjects
OPTICAL coherence tomography, RETINAL detachment, PARS plana, VITRECTOMY, RETINAL surgery, VISUAL acuity
Abstract

Purpose: To analyse the postoperative foveal avascular zone (FAZ) area, superficial vessel density (SVD) and deep vessel density (DVD) and their correlation with functional (best‐corrected visual acuity, BCVA) and anatomical outcomes (foveal macular thickness, FMT) after surgery for rhegmatogenous retinal detachment (RRD) repair. Method: Patients with RRD eyes, successfully treated with a single pars plana vitrectomy (PPV) with gas tamponade and a minimum 12 months follow‐up, were re‐examined. Foveal avascular zone (FAZ) area, SVD, DVD and FMT were evaluated by using optical coherence tomography angiography (OCTA) and compared to fellow eye. Results: Fifty‐six patients with macula‐on and 37 with macula‐off RRD were included in the study. In both groups, no difference in FMT and FAZ area was found compared to fellow eyes. In macula‐on RRD eyes, a lower parafoveal DVD (p = 0.001) was detected; FAZ area was related to FMT (p = 0.025), and the postoperative BCVA was correlated with parafoveal DVD (p = 0.010) and FAZ area (p = 0.003). In macula‐off RRD eyes, lower parafoveal SDV (p = 0.012), and foveal and parafoveal DVD (p = 0.012 and p < 0.001, respectively) were observed. BCVA was related to FAZ area (p = 0.012), foveal SVD (p = 0.005) and parafoveal DVD (p = 0.010). Conclusion: Rhegmatogenous retinal detachment eyes successfully treated with PPV had lower vessel density in the superficial and deep retinal plexus compared to fellow healthy eyes; BCVA was related to FAZ area and vessel density. [ABSTRACT FROM AUTHOR]

Published
2020
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115. Retinal Changes Induced by Epiretinal Tangential Forces

Author

Romano, Mario R., Comune, Chiara, Ferrara, Mariantonia, Cennamo, Gilda, De Cillà, Stefano, Toto, Lisa, and Cennamo, Giovanni

Subjects
genetic structures, Article Subject, sense organs, eye diseases
Abstract

Two kinds of forces are active in vitreoretinal traction diseases: tangential and anterior-posterior forces. However, tangential forces are less characterized and classified in literature compared to the anterior-posterior ones. Tangential epiretinal forces are mainly due to anomalous posterior vitreous detachment (PVD), vitreoschisis, vitreopapillary adhesion (VPA), and epiretinal membranes (ERMs). Anomalous PVD plays a key role in the formation of the tangential vectorial forces on the retinal surface as consequence of gel liquefaction (synchysis) without sufficient and fast vitreous dehiscence at the vitreoretinal interface. The anomalous and persistent adherence of the posterior hyaloid to the retina can lead to vitreomacular/vitreopapillary adhesion or to a formation of avascular fibrocellular tissue (ERM) resulting from the proliferation and transdifferentiation of hyalocytes resident in the cortical vitreous remnants after vitreoschisis. The right interpretation of the forces involved in the epiretinal tangential tractions helps in a better definition of diagnosis, progression, prognosis, and surgical outcomes of vitreomacular interfaces.

Published
2015
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116. Characterization and topographical analysis of choroidal caverns in young and healthy individuals

Author

Fragiotta, Serena, Toto, Lisa, Parravano, Mariacristina, Quarta, Alberto, Di Noia, Michele, Sacconi, Riccardo, Dobovsek Divjak, Darja, Rissotto, Federico, Polito, Maria Sole, Costanzo, Eliana, and Querques, Giuseppe

Abstract

Purpose To describe and clarify a possible pathogenetic origin for choroidal caverns in young healthy individuals through a topographical analysis using swept-source optical coherence tomography angiography (SS-OCTA).Methods A cross-sectional evaluation of 44 healthy volunteers (44 eyes), aged 20–32 years with no systemic or ocular comorbidities. The topographical analysis of choroidal caverns was performed through a 15 × 15 mm volumetric scan cube using SS-OCTA (PLEX Elite 9000). The number, topographic localization within the perifovea and midperipheral retina, as well as the density of choroidal caverns in the area with the highest number, were analyzed. Factors influencing the presence of choroidal caverns were identified using a logistic regression model.Results The overall prevalence of choroidal caverns was 18.2% in our cohort. The subjects exhibiting choroidal caverns presented a greater AXL (+1.19 mm, 95%CI: 0.09, 2.29). Areas with the highest density of caverns presented an average of 1.98 ± 1.01 caverns/mm2. On a qualitative evaluation, the area with the highest density was along the inferior vascular arcade in 6/8 (75%) eyes. The main predictor of choroidal cavern development was represented by AXL (adjusted risk ratio of 2.13, P= 0.02).Conclusion Choroidal caverns in young, healthy individuals may form due to mechanical stress in predisposed eyes, where an increased lateral and anteroposterior choroidal stretching due to globe elongation can result in the formation of these cavities. Future longitudinal studies are encouraged to understand their prognostic implications.

Published
2024
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117. Real-world experience with fluocinolone acetonide intravitreal implant in patients with diabetic macular edema

Author

Capone, Luigi, Airaghi, Pietro, Aragona, Pasquale, Castellino, Nicolò, Cicinelli, Maria Vittoria, Ciucci, Francesco, Coppola, Michele, Gaetano, Cristiano De, Lattanzio, Rosangela, Lorusso, Massimo, Maceroni, Martina, Malvasi, Maria Elena, Marco, Luisa, Marraffa, Michele, Martini, Gaia, Mastropasqua, Rodolfo, Minnella, Angelo Maria, Nikolopulou, Eleni, Ortisi, Elina, Pacella, Elena, Papa, Vincenzo, Pennesi, Claudio, Reibaldi, Michele, Rizzo, Stanislao, Toto, Lisa, Trombetta, Luigi, and Bandello, Francesco

Abstract

Objectives to evaluate long-term effectiveness and safety of fluocinolone acetonide (FAc) implant used as second-line treatment in patients with persistent diabetic macular edema (DME).Methods retrospective data chart review of 241 pseudophakic eyes of 178 patients treated with FAc from July 2017 to December 2021 in 10 medical retinal units in Italy. The primary endpoint was the change of best-corrected visual acuity (BCVA) and central macular thickness (CMT) at 2 years. A Student's paired t-test was used. Additional therapies for DME and intraocular pressure (IOP)-related events were also evaluated.Results efficacy of FAc was assessed in a subset of 111 eyes with at least 24 months of follow-up. Mean BCVA increased at 2 years by 5.1 ETDRS letters (95%CI = 2.6–7.5; p< 0.001) while mean CMT decreased by 189 µm (95% CI 151–227; p< 0.001). Thirty-eight of these eyes (34.2%) needed additional intravitreal treatments, mainly anti-VEGF. Safety was evaluated on the entire cohort of 241 eyes treated with FAc. Overall, 66 eyes (27.4%) required emergent IOP-lowering medications (typically within the first-year post FAc) while 14 eyes (5.8%) underwent trabeculectomy, mostly during the second year of follow-up.Conclusion FAc implant provides a substantial long-term functional and anatomical benefit when used as second-line treatment in eyes with DME. IOP rise can be adequately managed with topical agents although some eyes may require IOP-lowering surgery.

Published
2024
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118. Multimodal imaging in ophthalmology

Author

Toto, Lisa, dell'Omo, Roberto, Tosi, Gian Marco, Querques, Giuseppe, Zweifel, Sandrine A, Labbé, Antoine, Toto, Lisa, dell'Omo, Roberto, Tosi, Gian Marco, Querques, Giuseppe, Zweifel, Sandrine A, and Labbé, Antoine

Published
2016

123. BESTROPHINOPATHY

Author

Toto, Lisa, primary, Boon, Camiel J. F., additional, Di Antonio, Luca, additional, Battaglia Parodi, Maurizio, additional, Mastropasqua, Rodolfo, additional, Antonucci, Ivana, additional, Stuppia, Liborio, additional, and Mastropasqua, Leonardo, additional

Published
2016
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128. Multimodal Imaging in Ophthalmology

Author

Toto, Lisa, primary, dell’Omo, Roberto, additional, Tosi, Gian Marco, additional, Querques, Giuseppe, additional, Zweifel, Sandrine A., additional, and Labbé, Antoine, additional

Published
2016
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134. Association between outer retinal alterations and microvascular changes in intermediate stage age-related macular degeneration: an optical coherence tomography angiography study.

Author

Toto, Lisa, Borrelli, Enrico, Mastropasqua, Rodolfo, Di Antonio, Luca, Doronzo, Emanuele, Carpineto, Paolo, and Mastropasqua, Leonardo

Abstract

Aims: To investigate associations between changes in retinal vessels and alterations detected by spectral domain optical coherence tomography (SD-OCT) scans in intermediate stage age-related macular degeneration (AMD). Methods: Thirty eyes of 30 patients with intermediate dry AMD were enrolled in the study. Of the cohort study, 15 eyes (changes-AMD group) showed OCT changes preceding the development of drusen-associated atrophy. A control group of healthy subjects was selected for statistical comparisons. All patients underwent an ophthalmologic evaluation, including OCT angiography (OCTA) and SD-OCT scans. Main outcome measures were superficial vessel density, deep vessel density, macular thickness. Results: Foveal macular thickness was 215.2±32.9 µm in changes-AMD patients and was significantly thinner than no changes-AMD patients (248.3±23.3 µm, p=0.002) and healthy subjects (268.1±19.2 µm, p<0.0001). Furthermore, in the parafoveal area, the thicknesses of both the inner retina and the outer retina were reduced in the changes-AMD group, after comparison with the two other groups. Parafoveal superficial vascular plexus flow density was 43.3±2.7% in changes-AMD patients and was decreased compared with the no changes-AMD group (48.7±3.3%, p=0.003) and healthy controls (50.4±6.1%, p=0.001). A direct correlation of the superficial plexus flow density with the inner retina parafoveal macular thickness (R2=0.761, p=0.028) was found. Conclusions: We demonstrated an association between SD-OCT signs and retinal blood supply in patients with intermediate AMD and we showed that patients with signs predicting development of geographic atrophy have a reduced flow in superficial vascular plexus and damage of the inner and the outer retina. [ABSTRACT FROM AUTHOR]

Published
2017
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140. Pharmacotherapy of Central Serous Chorioretinopathy: A Review of the Current Treatments

Author

Iacono, Pierluigi, Toto, Lisa, Costanzo, Eliana, Varano, Monica, and Parravano, Maria C.

Abstract

Background: Central serous chorioretinopathy (CSC) is the fourth most frequent retinal disorder in terms of prevalence. It typically occurs in young subjects and affects men more often than women. CSC is characterized by serous retinal detachment (SRD) involving mainly the macular area. The clinical course is usually selflimited, with spontaneous resolution within 3 months. The persistence of SRD or multiple relapse may result in a chronic form of CSC distinguished by permanent retinal pigment epithelium (RPE) and photoreceptor damage. As the pathogenetic mechanism of CSC primarily involves RPE and choroidal vascularization, the current therapeutic approaches aim to restore the normal functions of RPE and normal choroidal vascular permeability. In this review, the authors aim to summarize the current therapeutic approach to CSC. Methods: A comprehensive review of the literature was conducted in PubMed by searching for relevant studies on the current therapeutic options for CSC, including simple observation, conventional laser treatment, subthreshold laser treatment (SLT), photodynamic therapy (PDT) with verteporfin, treatment with mineralocorticoid receptor (MR) antagonists and treatment with anti-vascular endothelial growth factor drugs. Results: Since most cases resolve spontaneously, the most common initial CSC treatment is observation. Current evidence suggests that PDT and SLT are valuable in improving visual acuity, reducing subretinal fluid and maintaining long-term effectiveness. No clear evidence of efficacy has been achieved for anti-VEGF. MR antagonists might be a viable choice for the treatment of chronic CSC. Conclusion: The pathophysiology of CSC remains poorly understood and as a consequence, the gold standard of care for CSC is yet to be defined. To date, PDT and SLT continue to offer good clinical outcomes. Positive preliminary results seem to emerge from the studies of MR antagonists.

Published
2018
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146. Immunohistochemical study of corneal inflammation after femtosecond laser clear corneal incisions or manual surgery.

Author

Toto, Lisa, Curcio, Claudia, Mastropasqua, Alessandra, Mattei, Peter A., D'Ugo, Erminia, De Nicola, Chiara, and Mastropasqua, Leonardo

Subjects
*KERATITIS, *CORNEA surgery, *FEMTOSECOND lasers
Abstract

Purpose To use immunohistochemical staining to evaluate corneal inflammation and apoptosis induced after femtosecond laser incisions or manual incisions. Setting Ophthalmology Clinic, University G. d’Annunzio, Chieti, Italy. Design Experimental study. Methods Ninety human cadaver corneas were cut manually or with the femtosecond laser at different energies and analyzed by immunohistochemistry after 5 minutes or 4 hours. The corneas were divided into 5 groups: untreated (Group 1), cut manually (Group 2), and treated with the femtosecond laser with increasing energies (Groups 3 to 5; 3.0 μJ, 6.0 μJ, and 15.0 μJ, respectively). Results At 5 minutes, increased expression of interleukin (IL)-18 was observed in the femtosecond laser groups compared with the manual group ( P < .01). Interferon gamma (IFNγ) positivity was significantly higher in Groups 4 and 5 than in Group 2 and between Groups 3 and 4 ( P < .05). The terminal uridine deoxynucleotidyl nick end-labeling (TUNEL) positivity increased with higher energy (Group 2 versus Group 4 and Group 2 versus Group 5; P < .05). After 4 hours, IFNγ positivity was higher in Group 5 than in Group 2 ( P = .0021) and between Group 5 and Groups 3 and 4 ( P < .05). No sign of IL-18 positivity was found after 4 hours in any sample. Group 5 showed significant higher TUNEL positivity than all other groups ( P < .0001). Conclusion The femtosecond laser technique at high energies induced a higher corneal inflammatory response and a higher corneal cell apoptosis than the manual technique. Financial Disclosure None of the authors has a financial or proprietary interest in any material or method mentioned. [ABSTRACT FROM AUTHOR]

Published
2016
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147. Reproducibility and repeatability of foveal avascular zone measurements in healthy subjects by optical coherence tomography angiography.

Author

Carpineto, Paolo, Mastropasqua, Rodolfo, Marchini, Giorgio, Toto, Lisa, Di Nicola, Marta, and Di Antonio, Luca

Subjects
STATISTICAL reliability, OPTICAL coherence tomography, ANGIOGRAPHY, INTRACLASS correlation, MICROCIRCULATION
Abstract

Background/aims To assess the reproducibility and repeatability of foveal avascular zone (FAZ) area measurements using optical coherence tomography angiography (OCT-A) in healthy subjects. Methods Sixty healthy volunteers (60 eyes) were subjected to FAZ area measurements by means of high speed and high resolution spectral-domain OCT (SD-OCT) XR Avanti with the split-spectrum amplitude decorrelation angiography algorithm by two experienced examiners in two different sessions. Results The mean±SD age of the subjects was 28.9 ±7.6 years. Overall FAZ areas measured by the first and second observer were 0.251±0.096 mm² and 0.252±0.096 mm², respectively. Within subjects, the coefficients of variations were 1.83% (95% CI 1.51% to 2.20%) and 1.86% (95% CI 1.33% to 2.43%) for the first and second observers, respectively. The coefficient of repeatability average measurements of FAZ area were 0.015 mm² and 0.013 mm² for the first and second observers, respectively. The intraclass correlation coefficient values were 0.997 (95% CI 0.995 to 0.998) and 0.998 (95% CI 0.996 to 0.999) for the first and second observers, respectively. Inter- and intraobserver concordance correlation coefficients ranged from 0.994 (95% CI 0.990 to 0.977) to 0.999 (95% CI 0.997 to 0.999) and from 0.997 (95% CI 0.995 to 0.998) to 0.996 (95% CI 0.994 to 0.998), respectively. Conclusions FAZ area measurements by means of OCT-A showed excellent reproducibility and repeatability in healthy eyes. OCT-A is a non-invasive diagnostic method, and its reliability makes it an interesting potential diagnostic tool for disease detection and follow-up in retinal pathologies involving foveal microcirculation. [ABSTRACT FROM AUTHOR]

Published
2016
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