510 results on '"Toto, Lisa"'
Search Results
152. Biocompatibility of hydrophilic intraocular lenses
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Tognetto, Daniele, primary, Toto, Lisa, additional, Ballone, Enzo, additional, and Ravalico, Giuseppe, additional
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- 2002
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153. Occult Choroidal Neovascularization in Adult-Onset Foveomacular Vitelliform Dystrophy
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Da Pozzo, Stefano, primary, Battaglia Parodi, Maurizio, additional, Toto, Lisa, additional, and Ravalico, Giuseppe, additional
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- 2001
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154. Pit defects on the anterior surface of hydrophilic foldable intraocular lenses
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Tognetto, Daniele, primary, Toto, Lisa, additional, and Ravalico, Giuseppe, additional
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- 2000
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155. Macular pseudohole development after sustainedrelease dexamethasone intravitreal implant for macular edema due to central retinal vein occlusion.
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Di Antonio, Luca, Toto, Lisa, Carpineto, Paolo, Mastropasqua, Alessandra, De Nicola, Chiara, and Mastropasqua, Leonardo
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- 2014
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156. Scanning electron microscopy evaluation of capsulorhexis in femtosecond laser–assisted cataract surgery.
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Mastropasqua, Leonardo, Toto, Lisa, Calienno, Roberta, Mattei, Peter A., Mastropasqua, Alessandra, Vecchiarino, Luca, and Di Iorio, Donato
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- 2013
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157. Retinal Structural Changes in a Case of Spontaneous Resolution of Vitreomacular Traction Syndrome: Multimodal Retinal Imaging Approach
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Di Antonio, Luca, Toto, Lisa, Aharrh-Gnama, Agbeanda, Ciciarelli, Vincenzo, Mastropasqua, Alessandra, and Carpineto, Paolo
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Purpose Retinal structural changes in a case of spontaneous resolution of vitreomacular traction (VMT) syndrome were followed by means of multimodal retinal imaging approach.Methods Confocal scanning laser ophthalmoscopy (cSLO) including digital infrared and blue reflectance (BR) imaging and spectral-domain optical coherence tomography (SD-OCT) were performed in a young man with VMT syndrome.Results At the time of diagnosis, multimodal retinal imaging documented outer retina abnormalities linked to VMT. At 1 month follow-up visit, improvement of best-corrected visual acuity and resolution of metamorphopsia were accompanied by documentation of VMT resolution and outer retina restoration.Conclusions Both cSLO and SD-OCT imaging, particularly BR and en face OCT adapted to the outer plexiform layer contour, allowed to depict outer retina changes in the course of VMT resolution. A strict correlation between topographic BR images and en face OCT scans was evident.
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- 2015
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158. Longterm results of 1 CU® accommodative intraocular lens implantation: 2-year follow-up study.
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Mastropasqua, Leonardo, Toto, Lisa, Falconio, Gennaro, Nubile, Mario, Carpineto, Paolo, Ciancaglini, Marco, Di Nicola, Marta, and Ballone, Enzo
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INTRAOCULAR lenses , *PHACOEMULSIFICATION , *ARTIFICIAL implants , *OPHTHALMIC lenses , *CLINICAL trials , *CATARACT surgery - Abstract
Purpose: To evaluate the longterm efficacy of 1 CU® accommodative intraocular lenses (IOLs) to restore near visual performance. Methods: This prospective study comprised 14 eyes previously included in a 6-month, case-control clinical trial, undergoing phacoemulsification and implantation of a 1 CU® accommodative IOL. The main outcome measures were subjective refraction, uncorrected distance visual acuity (UCDVA), best corrected distance VA (BCDVA), distance-corrected near VA (DCNVA), best corrected near VA (BCNVA), and subjective amplitude of accommodation (AA). In addition, anterior and posterior capsule opacification were assessed. Patients were examined over a 2-year follow-up period. Results: Distance and near visual performance worsened after 6 months. Uncorrected DVA and BCDVA were 0.8 ± 2.1 and 1.0 ± 0.8 at 6 months and 0.4 ± 0.1 and 0.6 ± 0.1 at 1 year, respectively (p = 0.001). Distance-corrected NVA and BCNVA were 3.7 ± 2.1 Jaeger (J) and 1.0 ± 0.7 J at 6 months and 8.1 ± 0.7 J and 1.5 ± 0.5 J at 1 year, respectively (p = 0.001). Anterior and posterior capsule opacification were present, respectively, in 28% and 21% of patients at 6 months and in 100% of patients at 1 and 2 years (p < 0.001). After Nd:YAG laser capsulotomy (performed in 100% of patients), UCDVA and BCDVA increased to 0.7 ± 0.2 (p = 0.007) and 1.0 ± 0.1 (p = 0.001), respectively, at 2 years. Distance-corrected NVA improved to 7.3 ± 0.5 J (p = 0.006). Mean AA was 1.9 ± 0.8 D at 6 months, 0.3 ± 0.2 D (p = 0.004) at 1 year and 0.3 ± 0.2 D at 2 years. Conclusions: Patients implanted with 1 CU® IOLs lost their accommodation capacities with time because of the high incidence and degree of anterior and posterior capsule opacification. The accommodative lens material and design may have played a role in capsule fibrosis. [ABSTRACT FROM AUTHOR]
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- 2007
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159. Glistenings in foldable intraocular lenses1 <FN ID="FN1"><NO>1</NO>None of the authors has a financial or proprietary interest in any material or method mentioned.</FN>
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Tognetto, Daniele, Toto, Lisa, Sanguinetti, Giorgia, and Ravalico, Giuseppe
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CATARACT surgery , *INTRAOCULAR lenses - Abstract
Purpose: To evaluate the formation of glistenings in foldable intraocular lenses (IOLs) of various materials after cataract surgery.Setting: University Eye Clinic of Trieste, Trieste, Italy.Methods: In this prospective study, 273 patients were randomized to have implantation of 1 of 7 types of foldable IOLs in the capsular bag after phacoemulsification. The IOLs were the CeeOn® Edge 911A (Pharmacia & Upjohn Co.), ACR6D® (Corneal), AcrySof® (Alcon), SI-40NB (AMO), Hydroview® H60M (Storz), Sensar® (AMO), and Stabibag® (Ioltech). The presence of glistenings in the IOL optic was assessed by slitlamp evaluation 7, 30, 90, 180, 360, and 720 days after surgery. The glistenings were graded at each control.Results: Glistenings were observed in all IOL groups. The percentage of patients with glistenings ranged from 40.0% to 67.5%, with the percentage increasing up to 90 days after surgery and then becoming stable in most groups. The AcrySof group had a continuous increase over time. The mean grade of glistenings increased up to 180 days after surgery and then became stable in most groups. The AcrySof and 911A groups had a continuous increase over time.Conclusions: Glistening formation was observed in 7 different foldable IOLs. The AcrySof group had a higher percentage and a greater density of glistenings. [Copyright &y& Elsevier]
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- 2002
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160. Visual Performance and Quality of Life after Femtosecond Laser-Assisted Cataract Surgery with Trifocal IOLs Implantation.
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Gallenga, Carla Enrica, D'Aloisio, Rossella, D'Ugo, Erminia, Vecchiarino, Luca, Agnifili, Luca, Simonelli, Maria Beatrice, Di Nicola, Marta, Toto, Lisa, and Perri, Paolo
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CATARACT surgery ,PHACOEMULSIFICATION ,CONTRAST sensitivity (Vision) ,ABERROMETRY ,QUALITY of life ,VISUAL acuity ,PATIENT satisfaction - Abstract
Purpose: To assess visual performance and quality of life after implantation of diffractive trifocal IOLs with enhanced depth of focus (Acriva Reviol Tri-ED) compared to monofocal IOLs. Setting: Ophthalmology Clinic, Department of Medicine and Science of Ageing, University "G. d'Annunzio" Chieti-Pescara, Italy. Design: Prospective clinical study. Methods: This study comprised 36 eyes of 18 patients with senile cataract candidates for phacoemulsification and implantation of the Acriva Reviol Tri-ED (Group 1–18 eyes) and the AcrySof IQ Monofocal IOL SN60WF (Group 2–18 eyes). The main outcome measures, over a 6-month follow-up period, were uncorrected and corrected visual acuity at different distances (40, 60 cm and 4 m), defocus curve, contrast sensitivity and wavefront error. Patient satisfaction was evaluated by means of the NEI-RQL-42 questionnaire. Results: At 180 days postoperatively, the difference of the UCDVA and CDVA between the groups was not statistically significant (p = 0.888 and p = 0.843, respectively). The difference between the groups was statistically significant for UCIVA (p = 0.019) and UCNVA (p = 0.036). The mean values of contrast sensitivity under photopic and mesopic conditions were not significantly different between the groups. The RMS of spherical aberration was significantly lower in Group 1 compared to Group 2. The NEI-RQL-42 questionnaire showed statistically significant differences between the groups for the dependence on correction (p < 0.001). Conclusions: The diffractive trifocal IOL with enhanced depth of focus Acriva Reviol Tri-ED was effective in improving functional capacity for intermediate and near vision compared to monofocal IOLs and provided a good quality of vision due to a significant reduction in spherical aberration. [ABSTRACT FROM AUTHOR]
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- 2021
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161. Early Vascular and Functional Changes after Vitreoretinal Surgery: A Comparison between the Macular Hole and Epiretinal Membrane.
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D'Aloisio, Rossella, Carpineto, Paolo, Aharrh-Gnama, Agbéanda, Iafigliola, Carla, Cerino, Luca, Di Nicola, Marta, Porreca, Annamaria, Toto, Lisa, and Mastropasqua, Rodolfo
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VITRECTOMY ,FLUORESCENCE angiography ,OPTICAL coherence tomography ,VISUAL acuity ,TREATMENT effectiveness - Abstract
(1) Background: The aim of this observational comparative study was to investigate early retinal vascular and functional changes in patients undergoing vitreoretinal surgery for idiopathic epiretinal membrane (iERM) or macular hole (MH) using a widefield swept-source optical coherence tomography angiography (WSS-OCTA). (2) Methods: Forty one diseased eyes were enrolled in the study. Twenty three eyes with iERM diagnosis (ERM group) underwent 25-gauge vitrectomy with inner limiting membrane (ILM) and MER peeling, while eighteen eyes with MH (MH group) underwent 25-gauge vitrectomy with inverted flap technique. Functional and anatomical/perfusion parameters were evaluated pre- and postoperatively in all eyes by means of WSS-OCTA system, microperimetry (MP3), best corrected visual acuity assessment, central macular thickness (CMT) and MH diameter calculation. For each eye, 12 × 12 mm OCTA volume scans were acquired by a retinal specialist and a semi-automated algorithm was used for a quantitative vessel analysis of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris (CC). In detail, perfusion density (PD) of the SCP, DCP and CC was evaluated in four circles (one central in the macular area of 5 mm diameter; three midperiphery circles (temporal, superior and inferior) of 3 mm). In addition, the vessel length density (VLD) of the SCP and DCP for the same circles was quantified. (3) Results: In the MH group, PD of the SCP significantly increased in the macular area (p = 0.018) and in the superior ring (p = 0.016); PD of the DCP significantly increased in the macular area (p = 0.015) and in the superior and inferior ring (p = 0.016) 3 months after surgery. In the ERM group, PD of the SCP and DCP significantly increased in the macular area and superior ring, respectively (p = 0.001; p = 0.032), 3 months after surgery. During follow-up there was a significant improvement in terms of functional (Best corrected visual acuity, p = 0.007 and p = 0.029; microperimetry ((MP3) 10°, p = 0.003 and p = 0.004; MP3 2°, p = 0.028 and p = 0.003 in MH group and ERM group respectively) and anatomical parameters (CMT, p = 0.049 in ERM group; hole complete closure in MH group). (4) Conclusions: After vitreoretinal surgery, early retinal vascular and functional changes can be promptly observed and quantified to monitor and potentially predict surgery outcomes. Widefield OCTA devices allow for a detailed microvasculature analysis of retina and choriocapillaris in the macular area and in the periphery, showing a different behaviour of retinal sectors in two distinct vitreoretinal disorders. [ABSTRACT FROM AUTHOR]
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- 2021
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162. Longterm results of 1?CU®accommodative intraocular lens implantation: 2-year follow-up study
- Author
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Mastropasqua, Leonardo, Toto, Lisa, Falconio, Gennaro, Nubile, Mario, Carpineto, Paolo, Ciancaglini, Marco, Di Nicola, Marta, and Ballone, Enzo
- Abstract
To evaluate the longterm efficacy of 1?CU®accommodative intraocular lenses (IOLs) to restore near visual performance.
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- 2007
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163. Changes in Iris Perfusion Following Scleral Buckle Surgery for Rhegmatogenous Retinal Detachment: An Anterior Segment Optical Coherence Tomography Angiography (AS-OCTA) Study.
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D'Aloisio, Rossella, Viggiano, Pasquale, Borrelli, Enrico, Parravano, Mariacristina, Agbèanda, Aharrh-Gnama, Evangelista, Federica, Ferro, Giada, Toto, Lisa, and Mastropasqua, Rodolfo
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OPTICAL coherence tomography ,RETINAL surgery ,RETINAL detachment ,ANGIOGRAPHY ,PERFUSION ,MECHANICAL buckling - Abstract
Purpose: To investigate iris vasculature changes following scleral buckling (SB) surgery in eyes with rhegmatogenous retinal detachment (RRD) with anterior-segment (AS) optical coherence tomography angiography (OCTA). Methods: In this prospective study, enrolled subjects were imaged with an SS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). Image acquisition of the iris was obtained using an AS lens and a manual focusing adjustment in the iris using the retina imaging software. The quantitative analysis was performed in eight different iris regions: (i) superior, (ii) supero-temporal, (iii) supero-nasal, (iv) nasal, (v) temporal, (vi) inferior, (vii) infero-temporal, (viii) infero nasal which, were defined as squares with area of 1.5 mm
2 . Results: Fifteen eyes of 15 patients (six females; nine males) were included. Anterior segment optical coherence tomography angiography (AS-OCTA) parameters of the iris were statistically compared at baseline (preoperatively), 1 week, 1 month and 6 months after SB. At post-operative 1 week, perfusion density (PD) showed a significant decrease from 66.8 ± 13.2% to 58.55 ± 12.0% in the iris supero-nasal region (p = 0.016). However, at the 1-month follow-up visit, iris PD was significantly lower in all the analyzed iris regions, apart from the superior one. Conclusions: This study is the first description of AS-OCTA in patients undergoing SB. Our results showed a uniform reduction of the iris vessel network at 1 month after surgery, supporting the clinical use of AS-OCTA to identify early iris perfusion changes as potential predictive biomarkers of vascular disorders. [ABSTRACT FROM AUTHOR]- Published
- 2020
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164. Capsular block syndrome associated with horizontal jerk nystagmus1 <FN ID="FN1"><NO>1</NO>None of the authors has a financial interest in any material or method mentioned.</FN>
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Tognetto, Daniele, Toto, Lisa, Michieli, Cinzia, and Ravalico, Giuseppe
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NYSTAGMUS , *INTRAOCULAR lenses , *PHACOEMULSIFICATION - Abstract
A 78-year-old cataract patient with horizontal jerk nystagmus had phacoemulsification and intraocular lens (IOL) implantation in the capsular bag with continuous curvilinear capsulorhexis. One week postoperatively, the posterior capsule ballooned posteriorly, the anterior capsule opening was sealed to the IOL optic, and a transparent liquefied substance accumulated between the lens optic and the posterior capsule. The best corrected visual acuity was 0.6 with a myopic shift compared with the refraction after the first day. A neodymium:YAG laser posterior capsulotomy was performed, and the capsular block syndrome (CBS) resolved. The results confirm the experimental model proposed by Zacharias suggesting that saccadic eye movements contribute to CBS under certain anatomic conditions. [Copyright &y& Elsevier]
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- 2002
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165. Correlation between Choriocapillaris Density and Retinal Sensitivity in Stargardt Disease.
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Mastropasqua, Rodolfo, Senatore, Alfonso, Di Antonio, Luca, Di Nicola, Marta, Marchioni, Michele, Perna, Fabiana, Amore, Filippo, Borrelli, Enrico, De Nicola, Chiara, Carpineto, Paolo, and Toto, Lisa
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STARGARDT disease ,OPTICAL coherence tomography ,LIGHT sources ,DENSITY - Abstract
The aim of this work was to characterize the choriocapillaris (CC) in patients with Stargardt disease (STGD) using the swept source widefield optical coherence tomography angiography (SS WF OCTA) and to compare CC perfusion density to retinal sensitivity, analyzed using microperimetry (MP). This cross-sectional study included 9 patients (18 eyes) with STGD and central CC atrophy (stage 3 STGD). The CC was analyzed using SS WF OCTA and areas of different CC impairment were quantified and correlated with retinal sensitivity analyzed using MP. The main outcome measures were the percent perfused choriocapillaris area (PPCA), retinal sensitivity, and correlation between PPCA and retinal sensitivity. Seventeen eyes of 9 patients suffering from stage 3 STGD were analyzed. SS WF OCTA revealed a vascular rarefaction in central atrophic zones and a near atrophy halo of choriocapillaris impairment. In all eyes were noticed a central atrophy (CA) area with absolute absence of CC that corresponded to 0 dB points at MP, a near atrophy (NA) zone of PPCA impairment that included points with decreased sensitivity at MP and a distant from atrophy (DA) zone with higher PPCA and retinal sensitivity values. The mean difference of PPCA and retinal sensitivity between NA and CA and DA and CA was statistical significantly different (p < 0.01), the latter showing higher values. A direct relationship between PPCA and retinal sensitivity was found (p < 0.001). Choriocapillaris damage evaluated using SS WF OCTA correlates with MP, these data suggest that CC impairment may be a predictor of retinal function in patients with STGD. [ABSTRACT FROM AUTHOR]
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- 2019
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166. Retinal vascular changes and aqueous humor cytokines changes after aflibercept intravitreal injection in treatment-naïve myopic choroidal neovascularization.
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Di Antonio, Luca, Toto, Lisa, Mastropasqua, Alessandra, Brescia, Lorenza, Erroi, Emanuele, Lamolinara, Alessia, Di Nicola, Marta, and Mastropasqua, Leonardo
- Abstract
The aim of the study was to assess retinal vascular changes using optical coherence tomography angiography (OCTA) and aqueous humour changes of vascular endothelial growth factor (VEGF) and placental growth factor (PIGF) levels in treatment-naïve myopic choroidal neovascularization (mCNV) after aflibercept intravitreal injection. To explore the correlation between clinical and laboratory parameters. Fifteen eyes of 15 patients with treatment-naïve mCNV underwent 2 intravitreal injections of aflibercept. Main outcome measures were best corrected visual acuity (BCVA), central retinal thickness (CRT) and external limiting membrane (ELM) visualization at OCT, lesion area and leakage at fluorescein angiography (FA), OCTA flow area and selected area at baseline and after the injections. Analysis of VEGF and PlGF in the aqueous humor was performed before each injection in cases and prior to cataract surgery on 10 patients as included as controls. Median BCVA increased from 0.6 to 0.3 logMAR (p < 0.001); CRT decreased from 387.5 to 267 micron (p < 0.001); FA area from 0.8 to 0.5 mm2 and OCTA area from 0.9 to 0.5 mm2 (p = 0.005). PIGF values changed from 1.8 to 1.4 pg/ml (p = 0.019) and VEGF values from 3.4 to 0.5 pg/ml (p = 0.008). A significant correlation was found after treatment between PIGF levels and BCVA (rho = 0.006) and VEGF levels and BCVA (rho = 0.018); between PlGF and CRT (rho = 0.020), PlGF and ELM visualization (rho = 0.002) and PlGF and FA leakage (rho < 0.001). Our results showed a significant reduction of mCNV area after aflibercept in both FA and OCTA measurements; an improvement of BCVA, and a reduction of VEGF and PIGF levels related to inactivity of the disease. [ABSTRACT FROM AUTHOR]
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- 2018
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167. Analysis of Macular Pigment Optical Density in Macular Holes with Different Border Phenotypes.
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Quarta, Alberto, Gironi, Matteo, Ruggeri, Maria Ludovica, Porreca, Annamaria, D'Aloisio, Rossella, Toto, Lisa, Di Nicola, Marta, and Mastropasqua, Rodolfo
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OPACITY (Optics) , *PIGMENT analysis , *OPTICAL coherence tomography , *PHENOTYPES - Abstract
Introduction: We conducted a cross-sectional study to compare macular pigment optical density (MPOD) in eyes with idiopathic macular holes with bumpy (bbMH) and smooth borders (sbMH) and to assess the relation between MPOD and optical coherence tomography findings. Thirty eyes from thirty patients affected by idiopathic macular hole were studied. Methods: All patients underwent SD-OCT and macular pigment optical density (MPOD) analysis. Comparison between the two border phenotypes were estimated at baseline, as well as the differences in MPOD, minimum and basal hole diameter, tractional hole index (THI), macular hole index (MHI), diameter hole index (DHI), and ELM integrity metrics between the two groups. Results: The mean MPOD was 0.09 ± 0.08 in bbMHs and 0.16 ± 0.11 in sbMHs (p = 0.010). Correlation analysis between MPOD and minimum hole diameter revealed a negative association (rho = − 0.707, p = 0.008) in bbMH and a positive association (rho = 0.702, p = 0.019) in sbMH. MPOD and basal diameter were negatively correlated in bbMH (rho = − 0.77, p = 0.001) and positively correlated in sbMH (rho = 0.675, p = 0.019). Indeed, MPOD is negatively correlated with THI and MHI in sbMH (rho = − 0.684 p = 0.019; rho = − 0.665 p = 0.019, respectively) and positively correlated in bbMH (rho = 0.593 p = 0.037; rho = 0.658 p = 0.018, respectively). Conclusions: MPOD is significantly reduced in bbMHs compared to sbMHs. The two border phenotypes also differ for tractional and tangential indexes, possibly reflecting a different pathogenesis. Further studies are needed to understand the prognostic role of MPOD. [ABSTRACT FROM AUTHOR]
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- 2024
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168. Baseline imaging characteristics and early structural changes in macula on rhegmatogenous retinal detachment.
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Quarta, Alberto, Gironi, Matteo, Ruggeri, Maria Ludovica, Aharrh-Gnama, Agbeanda, Porreca, Annamaria, D'Aloisio, Rossella, Toto, Lisa, Di Nicola, Marta, and Mastropasqua, Rodolfo
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RETINAL detachment , *AGE of onset , *MACULA lutea , *PHOTORECEPTORS , *LONGITUDINAL method , *PERFUSION , *OPTICAL coherence tomography , *FLUORESCENCE angiography - Abstract
Animal models have demonstrated that structural changes affect the macula during peripheral rhegmatogenous retinal detachment. This study aimed to assess photoreceptors, retinal and choriocapillaris perfusion in non-macula involving rhegmatogenous retinal detachment by analyzing en-face images from structural OCTA segmented at the ellipsoid zone (EZ) level, calculating (1) "normalized" reflectivity as a surrogate biomarker of photoreceptor damage (2) perfusion density (PD), vessel length density (VLD) and vessel diameter index (VDI) of superficial capillary plexus (SCP) and deep capillary plexus (DCP) (3) perfusion density of choriocapillaris (PDCC). Twenty-one eyes affected by macula-on rhegmatogenous retinal detachment (RRD) were enrolled at the University "G. d'Annunzio", Chieti-Pescara. The fellow unaffected eye was used as control. The mean age at the onset of RRD was 60.09 ± 10.22 (range 34–83). Compared with fellow eyes, we found lower EZ "normalized" reflectivity in macula-on (0.42 ± 0.15 in fellow eyes and 0.31 ± 0.09 in macula on p = 0.004). The affected eye was also characterized by impaired perfusion in SCP (17.26 ± 3.34% in macula on and 20.56 ± 3.62% in the fellow eye p = 0.004) and CC (50.21 ± 6.20% in macula on the eye and 57.43 ± 6.20% in the fellow eye p = 0.004). Macula-on rhegmatogenous retinal detachment has subclinical changes in photoreceptors, SCP, and CC. Future longitudinal studies should evaluate if early changes could impact post-operative macular function. [ABSTRACT FROM AUTHOR]
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- 2024
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169. Choriocapillaris Reperfusion in Resolved Chronic Central Serous Chorioretinopathy Treated with Eplerenone: Long-Term Effects on the Fellow Eye.
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Viggiano, Pasquale, Boscia, Giacomo, Borrelli, Enrico, Toto, Lisa, Grassi, Maria Oliva, Evangelista, Federica, Giancipoli, Ermete, Alessio, Giovanni, and Boscia, Francesco
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OPTICAL coherence tomography , *REPERFUSION , *MINERALOCORTICOID receptors , *VISUAL acuity , *ANGIOGRAPHY - Abstract
Introduction: The aim of this work is to utilize swept-source optical coherence tomography angiography (SS-OCTA) to assess the long-term changes in the choroidal and choriocapillaris (CC) layers of the fellow unaffected eye of patients with unilateral resolved chronic central serous chorioretinopathy (cCSC) following treatment with continuous oral eplerenone (EPL). Methods: The study included 35 patients with cCSC and subretinal fluid (SRF) in one eye. SS-OCTA imaging was performed on the fellow cCSC eyes at baseline, 6 months, and 12 months during eplerenone therapy. CC OCT angiography was analyzed to determine the percentage of choriocapillaris flow deficits (FD%), the number of flow deficits (FDn), and the average area of flow deficits (FDa). Results: The results demonstrated significant changes in CC flow deficits from baseline to follow-up visits. Specifically, there was a significant decrease in FD% from 28.9 ± 2.2% at baseline to 26.4 ± 1.9% at 6 months (p = 0.023), and further to 24.9 ± 1.7% at 12 months (p = 0.001). Additionally, the FD area gradually contracted over the follow-up period (p < 0.05). Conversely, there was a significant increase in the number of flow deficits compared to baseline (p < 0.05). No statistically significant changes were observed in best-corrected visual acuity (BCVA) at the follow-up visits (p > 0.05). Conclusions: The findings of this study demonstrated long-term reperfusion of the choriocapillaris in unaffected fellow cCSC eyes during continuous oral eplerenone therapy. The beneficial effects of eplerenone therapy were observed after 6 months and maintained at 1 year. These results suggest that specific mineralocorticoid receptor (MR) antagonists may be effective in promoting choriocapillaris recovery in the unaffected eyes of patients with cCSC. [ABSTRACT FROM AUTHOR]
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- 2023
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170. Corrigendum: Optical coherence tomography angiography microvascular findings in macular edema due to central and branch retinal vein occlusions.
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Mastropasqua, Rodolfo, Toto, Lisa, Di Antonio, Luca, Borrelli, Enrico, Senatore, Alfonso, Di Nicola, Marta, Di Martino, Giuseppe, Ciancaglini, Marco, and Carpineto, Paolo
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- 2017
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171. Two-surgeon, two-center evaluation of a new combined EDOF intraocular lens approach.
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Mastropasqua, Leonardo, Pedrotti, Emilio, Ruggeri, Maria Ludovica, Vecchiarino, Luca, Bonacci, Erika, Guarini, Daniele, Falconio, Gennaro, Toto, Lisa, and Marchini, Giorgio
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PHACOEMULSIFICATION , *INTRAOCULAR lenses , *PHOTOREFRACTIVE keratectomy , *REFRACTIVE errors , *CONTRAST sensitivity (Vision) , *VISUAL acuity , *PATIENT satisfaction - Abstract
The combined approach with Mini WELL and Mini WELL PROXA IOLs results in patient's satisfaction, with reported differences between the 2 IOLs in visual acuity, contrast sensitivity, and defocus curve. Purpose: To evaluate visual performance and quality of life after bilateral implantation of 2 extended depth-of-focus intraocular lenses (EDOF IOLs). Setting: Ophthalmology Clinic, Department of Medicine and Science of Ageing, University "G. d'Annunzio" Chieti-Pescara, Italy, and Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy. Design: Prospective clinical study. Methods: 60 eyes of 30 patients with senile cataract were enrolled in this study. Patients underwent phacoemulsification and bilateral implantation of the Mini WELL IOL in the dominant eye and the Mini WELL PROXA IOL in the nondominant eye within a month. The main outcome measures over a 3-month follow-up period were uncorrected and corrected visual acuity at different distances (33 cm, 60 cm, and 4 m), defocus curve, contrast sensitivity, and patient satisfaction (evaluated by mean of the National Eye Institute Refractive Error Quality-of-Life instrument-42 questionnaire). Results: Binocular uncorrected visual acuity at 90 days was 0.03 ± 0.11 logMAR for long distance, 0.05 ± 0.10 logMAR for intermediate distance, 0.03 ± 0.08 logMAR at 40 cm, and 0.06 ± 0.08 logMAR at 33 cm. Statistically significant differences between the 2 EDOF IOLs in favor of Mini WELL PROXA IOL were observed for uncorrected near visual acuity at 40 and 33 cm (P <.001 and P <.001, respectively) and for distance-corrected near visual acuity at 40 cm (P <.001). Significant differences between the 2 IOLs in the defocus curves were reported. Conclusions: In this small pilot study, bilateral implantation of Mini WELL IOL and Mini WELL PROXA IOL achieved good quantity and quality of vision. [ABSTRACT FROM AUTHOR]
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- 2023
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172. Choroidal and Retinal Vascular Findings in Patients with COVID-19 Complicated with Pneumonia: Widefield Imaging.
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D'Aloisio, Rossella, Ruggeri, Maria Ludovica, D'Onofrio, Giada, Formenti, Federico, Gironi, Matteo, Di Nicola, Marta, Porreca, Annamaria, Toto, Lisa, and Mastropasqua, Rodolfo
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COVID-19 , *POST-acute COVID-19 syndrome , *CHOROID , *OPTICAL coherence tomography , *PNEUMONIA , *POLYPOIDAL choroidal vasculopathy , *CHOROID diseases - Abstract
Purpose: The purpose of this study was to analyze choroidal and retinal vascular alterations of both the macula and midperiphery areas in patients hospitalized for COVID-19 infection complicated with pneumonia within 30 days from discharge. Methods: A total of 46 eyes of 23 subjects with a history of symptomatic COVID-19 infection and recent hospitalization for pneumonia were enrolled in this observational study. Patients had not been previously vaccinated against COVID-19. A group of patients homogenous for age and sex was enrolled as controls. Microvascular retinal and choroidal features of the enrolled patients were studied with widefield optical coherence tomography angiography (OCT-A). Perfusion parameters in terms of the vessel density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) and the choroidal vascularity index (CVI) on enhanced depth imaging (EDI) mode OCT scans were analyzed. Results: Our cohort of patients showed a trend of reduction in VD, significantly in the SCP VD of the superior and inferior midperiphery sectors, whereas the CVI did not show significant differences between the cases and controls. Moreover, a positive correlation between CVI and vessel density in the deep capillary plexus in the macular area (VD-DCP-MAC) was found. Conclusion: The systemic disease due to COVID-19 can also involve the retina and choroid with multiple mechanisms: ischemic and inflammatory. Our study showed changes in perfusion occurring in the eyes of patients with a recent hospitalization for COVID-19 complicated with pneumonia and without any possible ocular effect due to the vaccines. There is still the need to better comprise how long COVID-19 actually affects vascular changes in the eye. [ABSTRACT FROM AUTHOR]
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- 2023
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173. Bilateral Branch Retinal Vein Occlusion after mRNA-SARS-CoV-2 Booster Dose Vaccination.
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Gironi, Matteo, D'Aloisio, Rossella, Verdina, Tommaso, Shkurko, Benjamin, Toto, Lisa, and Mastropasqua, Rodolfo
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RETINAL vein occlusion , *BOOSTER vaccines , *FLUORESCENCE angiography , *DISEASE risk factors , *INTRAVITREAL injections - Abstract
Purpose: We report a case of a patient with a bilateral branch retinal vein occlusion (BRVO) 24 h after a booster vaccination with the mRNA-1237 vaccine. Observations: Fluorescein angiography, performed at three weeks follow-up, showed vascular leakage and blockage, corresponding to hemorrhage areas associated with ischemic areas in the macula and along the arcades involved in the occlusion. Conclusions: The patient was scheduled for urgent injections of intravitreal ranibizumab and laser photocoagulation of the ischemic areas. To the best of our knowledge, this is the first case described of concomitant bilateral RVO after COVID-19 vaccination. The rapid onset of the side effects in a patient with multiple risk factors for thrombotic events suggests that vulnerable microvascular conditions require detailed investigations before administration of a COVID-19 vaccine. [ABSTRACT FROM AUTHOR]
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- 2023
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174. Long-Term Macular Vascular Changes after Primary Rhegmatogenous Retinal Detachment Surgery Resolved with Different Tamponade or Different Surgical Techniques.
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Gironi, Matteo, D'Aloisio, Rossella, Verdina, Tommaso, Vivarelli, Chiara, Leonelli, Riccardo, Kaleci, Shaniko, Toto, Lisa, and Mastropasqua, Rodolfo
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RETINAL detachment , *RETINAL surgery , *OPERATIVE surgery , *MACULA lutea , *VISUAL acuity , *OPTICAL coherence tomography , *VISION disorders - Abstract
Simple Summary: Primary rhegmatogenous retinal detachment is an acute threat to visual impairment due to a retinal break that allows the passage of vitreous fluid into the subretinal space. Although it is clear that functional results are influenced by retinal detachment extension and surgical timing, we do not have definitive indications on post-operative changes in macular microcirculation and how they might affect visual performance. The study aims to evaluate the long-term macular vascular changes and their correlation with functional recovery in patients successfully treated for rhegmatogenous retinal detachment. We found a reduction of the vascular density in the operated eyes, not influenced by surgical techniques, independently from the pre-operative detachment extension. However, we found that functional recovery is influenced by different intraoperative choices. In conclusion, such visual acuity and microvascular changes can be considered biomarkers that highlight the relevance of careful management of this sight-threatening disease. Background: The aim of this study was to assess long-term macular vascular changes and their correlation with functional recovery in patients successfully treated for Macula-ON and Macula-OFF rhegmatogenous retinal detachment (RRD). Methods: This retrospective observational study included 82 eyes of 82 patients who received primary successful retinal detachment surgery, 33 Macula-ON and 49 Macula-OFF. Superficial and deep capillary plexuses (SCP and DCP) were evaluated by optical coherence tomography angiography (OCTA), and were correlated with visual acuity (VA), surgical technique and tamponade at 12 months after surgery. The fellow eyes were used as controls. Results: At 12-month follow-up, there was a significant decrease in the vessel density (VD) in the SCP in the operated eyes compared to control eyes (p < 0.05) in both the Macula-ON and Macula-OFF groups. Vessel length density (VLD) decrease in SCP was more extended in the Macula-OFF group. No difference in the DCP perfusion parameters was found, compared to controls. Subgroup analysis dependent on the type of surgery or tamponade showed no significant differences of VD and VLD. An inverse correlation was found between the SCP VD and the duration of silicone oil (SO) tamponade (p = 0.039). A significant correlation was observed between parafoveal SCP VD and final best corrected visual acuity (BCVA) (p = 0.028). The multivariate linear regression analysis showed that only the type of tamponade was significantly correlated with the final BCVA in the Macula-ON group (p = 0.004). Conclusions: Our study described long-term perfusion changes in RRD after surgery, with lower SCP VD and VLD in the operated eyes compared to the fellow ones, not influenced by type of surgery or tamponade. The choice of tamponade and SO removal timing may affect functional outcomes, especially in Macula-ON RRD. In conclusion, such functional and perfusion changes can be considered biomarkers that highlight the relevance of careful management of this sight-threatening disease. [ABSTRACT FROM AUTHOR]
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- 2022
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175. In Vivo Mapping of the Choriocapillaris in High myopia: a Widefield Swept Source Optical Coherence Tomography Angiography.
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Mastropasqua, Rodolfo, Viggiano, Pasquale, Borrelli, Enrico, Evangelista, Federica, Libertini, Daniele, Di Antonio, Luca, and Toto, Lisa
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MYOPIA , *OPTICAL coherence tomography , *ANGIOGRAPHY , *ALGORITHMS , *QUANTITATIVE research - Abstract
To report variation of choriocapillaris (CC) flow in widefield in high in myopic subjects compared with an age-matched normal control group using ultra widefield optical coherence tomography angiography (UW-OCTA). This is a Prospective, cross-sectional study. Thirty high myopia subjects and fifty healthy subjects were enrolled. Healthy and high myopia subjects were imaged with the SS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). For each eye, five 12 × 12-mm OCTA volume scans were acquired. The en face CC images were then exported to imageJ and a semi-automated algorithm was used for subsequent quantitative analysis. The main outcome was a quantitative analysis of the CC. This analysis was performed in three different regions: (i) peripapillary, (ii) macular, and (iii) periphery. In addition, CC variables were further investigated in distinct fields within these three different regions. Thirty myopic eyes (32 subjects; myopic group) and fifty eyes (50 subjects; control group) without elevated myopia were included in the analysis. Mean ± SD age was 26.9 ± 2.9 years [median: 27 years; range: 20.0–40.0 years]. Mean ± SD axial length was 26.6 ± 0.6 mm [median: 26.2 mm; range: 26.1 to 28.0 mm]. Mean ± SD axial length was 26.6 ± 0.6 mm [median: 26.2 mm; range: 26.1 to 28.0 mm] in the myopic group and 23.9 ± 1.1 mm [median: 23.9 mm; range: 21.8 to 25.9 mm] in the control group. The total signal void area was significantly greater in myopic eyes compared with control group. The peripapillary region exhibited the greatest total signal void area (p < 0.0001 vs macular region, p < 0.0001 vs peripheral region). Within the macular region, the foveal area exhibited a greater total signal void area in comparison with both the parafoveal area (p < 0.0001) and the perifoveal area (p < 0.0001). In conclusion we report quantitative mapping of the choriocapillaris in myopic eyes compared with an age-matched normal control group. The CC perfusion appears to have a wide topographical variation. [ABSTRACT FROM AUTHOR]
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- 2019
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176. Widefield optical coherence tomography angiography in diabetic retinopathy.
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Mastropasqua, Rodolfo, D'Aloisio, Rossella, Di Antonio, Luca, Erroi, Emanuele, Borrelli, Enrico, Evangelista, Federica, D'Onofrio, Giada, Di Nicola, Marta, Di Martino, Giuseppe, and Toto, Lisa
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OPTICAL coherence tomography , *DIABETIC retinopathy , *ANGIOGRAPHY , *RETINA - Abstract
Aims: To evaluate superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris (CC) perfusion in macular and near/mid periphery regions in diabetic patients using widefield swept-source optical coherence tomography angiography (WSS-OCTA). Methods: Ninety-four diabetic patients (94 eyes) classified as diabetics without diabetic retinopathy (no DR) (25 eyes), mild DR (23 eyes), moderate/severe DR (26 eyes), proliferative DR (20 eyes) and a control group of 25 healthy subjects (25 eyes) were imaged with the WSS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). Quantitative analysis was performed in the macular and peripheral regions. The main outcome measures were perfusion density (PD) and vessel length density of SCP, DCP and CC. Results: Peripheral retina (all sectors) showed lower SCP and DCP PD compared to the macular region (p < 0.001). In diabetics without DR and DR in different stages, SCP and DCP PD significantly decreased at advancing stages of DR (p < 0.001). At DCP level, central PD was significantly directly related to peripheral PD (superior, R = 0.682 and 0.479; temporal, R = 0.918 and 0.554; inferior, R = 0.711). A good sensitivity and an excellent specificity were found in terms of prediction of disease worsening, especially for central and temporal sectors in all plexuses and for all sectors both central and peripheral of DCP. Conclusions: The widefield OCTA is useful for the study of central and peripheral retina in diabetic patients with or without diabetic retinopathy, assessing good correlation between central and peripheral retina. [ABSTRACT FROM AUTHOR]
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- 2019
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177. Relationship between aqueous humor cytokine level changes and retinal vascular changes after intravitreal aflibercept for diabetic macular edema.
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Mastropasqua, Rodolfo, D’Aloisio, Rossella, Di Nicola, Marta, Di Martino, Giuseppe, Lamolinara, Alessia, Di Antonio, Luca, Tognetto, Daniele, and Toto, Lisa
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- 2018
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178. Vascular changes after vitrectomy for rhegmatogenous retinal detachment: optical coherence tomography angiography study
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Antonio Longo, Michele Rinaldi, Robert Rejdak, Katarzyna Nowomiejska, Iacopo Macchi, Mario Damiano Toro, Teresio Avitabile, Salvatore Cillino, Alessandra Pizzo, Davide Scollo, Elina Ortisi, Matteo Fallico, Andrea Russo, Lisa Toto, Giuseppe Faro, Michele Reibaldi, Vincenza Bonfiglio, 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, Longo, Antonio, Bonfiglio, V., Ortisi, E., Scollo, D., Reibaldi, M., Russo, A., Pizzo, A., Faro, G., Macchi, I., Fallico, M., Toro, M. D., Rejdak, R., Nowomiejska, K., Toto, L., Rinaldi, M., Cillino, S., Avitabile, T., and Longo, A.
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Pars plana ,medicine.medical_specialty ,Visual acuity ,genetic structures ,medicine.medical_treatment ,vitrectomy ,Vitrectomy ,foveal avascular zone ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Foveal ,Ophthalmology ,Medicine ,business.industry ,rhegmatogenous retinal detachment ,Retinal detachment ,Retinal ,General Medicine ,Optical coherence tomography angiography ,medicine.disease ,eye diseases ,medicine.anatomical_structure ,superficial and deep vessel density ,chemistry ,030221 ophthalmology & optometry ,sense organs ,Tamponade ,medicine.symptom ,business ,030217 neurology & neurosurgery - 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 12months 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 
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- 2019
179. Optical Coherence Tomography Angiography Findings in X-Linked Retinoschisis
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Rodolfo Mastropasqua, Lisa Toto, Luca Di Antonio, Ivana Antonucci, Luca Sorino, Maurizio Battaglia Parodi, Cesare Mariotti, Liborio Stuppia, Marta Di Nicola, Mastropasqua, Rodolfo, Toto, Lisa, Di Antonio, Luca, Parodi, Maurizio Battaglia, Sorino, Luca, Antonucci, Ivana, Stuppia, Liborio, Di Nicola, Marta, and Mariotti, Cesare
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Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Visual acuity ,Adolescent ,Fundus Oculi ,Retinoschisis ,Visual Acuity ,Retina ,Young Adult ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Ophthalmology ,Electroretinography ,medicine ,Humans ,Fluorescein Angiography ,Child ,medicine.diagnostic_test ,business.industry ,Healthy subjects ,Retinal ,Optical coherence tomography angiography ,Female ,Middle Aged ,Pedigree ,Tomography ,Optical Coherence ,030104 developmental biology ,medicine.anatomical_structure ,chemistry ,030221 ophthalmology & optometry ,Surgery ,X-linked retinoschisis ,Retinoschisi ,medicine.symptom ,Acetazolamide ,business ,Tomography, Optical Coherence ,Human ,medicine.drug - Abstract
BACKGROUND AND OBJECTIVE: The aim of the study was to determine optical coherence tomography angiography (OCTA) findings and to identify mutations in the RS1 gene in a three-generation family with X-linked juvenile retinoschisis (XLRS). PATIENTS AND METHODS: Clinical and genetic assessments were performed in 12 family members. OCTA was performed at baseline (12 members including cases and carriers) and after acetazolamide administration (three cases). Twenty healthy subjects (20 eyes, controls) were chosen for comparison. Molecular genetic analysis of the RS1 gene was performed in all family members. RESULTS: Deep capillary plexus density was reduced in cases compared with controls ( P < .01) and was negatively related with retinal thickness ( P < .05). After treatment, retinal thickness decreased ( P < .05) and deep capillary plexus density increased ( P < .05) in cases. In three cases and in four carriers, p.Arg197 His mutation was found. CONCLUSION: OCTA shows reduced macular deep vessel density in patients with XLRS probably related to vessel displacement and disruption due to schitic cysts. [ Ophthalmic Surg Lasers Imaging Retina . 2018;49:e20–e31.]
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- 2018
180. Relationship between aqueous humor cytokine level changes and retinal vascular changes after intravitreal aflibercept for diabetic macular edema
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Rodolfo Mastropasqua, Rossella D'Aloisio, Giuseppe Di Martino, Daniele Tognetto, Alessia Lamolinara, Lisa Toto, Luca Di Antonio, Marta Di Nicola, Mastropasqua, Rodolfo, D’Aloisio, Rossella, Di Nicola, Marta, Di Martino, Giuseppe, Lamolinara, Alessia, Di Antonio, Luca, Tognetto, Daniele, and Toto, Lisa
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0301 basic medicine ,Eotaxin ,Male ,genetic structures ,Computed Tomography Angiography ,medicine.medical_treatment ,Visual Acuity ,Vascular permeability ,Superficial Capillary Plexus (SCP) ,chemistry.chemical_compound ,0302 clinical medicine ,Edema ,Receptor ,Aflibercept ,Multidisciplinary ,Middle Aged ,Cytokine ,Treatment Outcome ,Intravitreal Injections ,Medicine ,Cytokines ,Female ,Diabetic Macular Edema (DME) ,medicine.symptom ,Tomography, Optical Coherence ,medicine.drug ,medicine.medical_specialty ,Central Macular Thickness (CMT) ,Science ,Recombinant Fusion Proteins ,Macular Edema ,Article ,Proinflammatory cytokine ,Aqueous Humor ,03 medical and health sciences ,Ophthalmology ,medicine ,Humans ,Aged ,Diabetic Retinopathy ,business.industry ,Retinal ,eye diseases ,030104 developmental biology ,Receptors, Vascular Endothelial Growth Factor ,chemistry ,Gene Expression Regulation ,Vascular Endothelial Growth Factor (VEGF) ,030221 ophthalmology & optometry ,sense organs ,business - Abstract
The aim of this work was to investigate the changes in aqueous humor cytokine levels after intravitreal injection of aflibercept in diabetic macular edema (DME) and to evaluate the relationship between cytokines modifications and central macular thickness (CMT) and retinal/choroidal vascular changes using structural and functional optical coherence tomography (OCT). Aqueous concentrations of 38 cytokines were measured via multiplex bead assay. In addition, spectral domain OCT and OCT angiography with SSADA software (XR Avanti® AngioVue) were performed at baseline and after intravitreal injections. VEGF, IL-6, IL-5, IL-1β, Eotaxin, GRO, IL-12p40, IL-12p70, IL-1RA, Flt-3L and IP-10 showed a statistically significant decrease through the follow-up (p
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- 2018
181. VASCULAR ALTERATIONS REVEALED WITH OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN PATIENTS WITH CHOROIDEREMIA
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Emanuela Aragona, Francesco Bandello, Maurizio Battaglia Parodi, Lisa Toto, Alessandro Arrigo, Robert E MacLaren, Maria Pia Manitto, Rodolfo Mastropasqua, Battaglia Parodi, Maurizio, Arrigo, Alessandro, Maclaren, Robert E, Aragona, Emanuela, Toto, Lisa, Mastropasqua, Rodolfo, Manitto, Maria Pia, and Bandello, Francesco
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Adult ,Male ,medicine.medical_specialty ,Fundus Oculi ,Genetic enhancement ,Degeneration (medical) ,Choroideremia ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Ophthalmology ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Fluorescein Angiography ,Prospective cohort study ,Retina ,Retinal pigment epithelium ,business.industry ,Choroid ,Retinal Vessels ,Retinal ,General Medicine ,Optical coherence tomography angiography ,Genetic Therapy ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,chemistry ,choroideremia ,en face ,OCT ,OCT angiography ,vessel density ,030221 ophthalmology & optometry ,Female ,sense organs ,business ,Tomography, Optical Coherence ,Follow-Up Studies - Abstract
Purpose Choroideremia is a rare degenerative retinal disease that causes incurable blindness. It occurs as a result of the deficiency of the X-linked CHM gene, which encodes the Rab escort protein 1 (REP1). Gene therapy has been developed to treat CHM using adeno-associated viral vectors and is currently undergoing clinical trials. Expression of the CHM gene is ubiquitous throughout the retina, and it is therefore important to identify which retinal layers are affected in the disease process. The purpose of this study was to assess in particular the choriocapillaris using optical coherence tomography angiography because this layer is difficult to see with conventional imaging techniques. Methods Six men with choroideremia were identified and underwent standardized optical coherence tomography angiography as part of an ethics-approved clinical study and were compared with age-matched control subjects. Results The choriocapillaris appeared normal in regions where the retinal pigment epithelium remained intact, but it was deficient elsewhere. The outer retinal vasculature showed significant changes peripherally but also some changes centrally. The inner retinal vasculature appeared unaffected by the disease process. Conclusion Choroideremia is a disease in which the choriocapillaris maintains a normal structure until the loss of the overlying retinal pigment epithelium. The inner retina also appears not to be affected at the vascular level. Although this study is limited by the small number of patients eligible for inclusion in the study, the observations support the concept of targeting gene therapy to the retinal pigment epithelium and outer retina because there is no evidence of independent degeneration of the choriocapillaris.
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- 2018
182. Multimodal Imaging in Ophthalmology
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Sandrine Zweifel, Antoine Labbé, Gian Marco Tosi, Giuseppe Querques, Roberto dell'Omo, Lisa Toto, Toto, L, Dell'Omo, R, Tosi, Gm, Querques, Giuseppe, Zweifel, Sa, Labbe, A., University of Zurich, and Toto, Lisa
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10018 Ophthalmology Clinic ,medicine.medical_specialty ,genetic structures ,Article Subject ,MEDLINE ,High resolution ,610 Medicine & health ,chemistry.chemical_compound ,lcsh:Ophthalmology ,Ophthalmology ,Medicine ,Multimodal imaging ,Retina ,Modalities ,business.industry ,Retinal ,2731 Ophthalmology ,Ophthalmology clinic ,medicine.anatomical_structure ,Editorial ,chemistry ,lcsh:RE1-994 ,Optometry ,sense organs ,business - Abstract
In recent years the use of different, established, and novel imaging techniques provided detailed insight into several retinal diseases. These modalities provide information about anatomy and functional changes in the retina with high resolution images which improve diagnosis and management of retinal pathologies.
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- 2016
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183. Bestrophinopathy: A spectrum of ocular abnormalities caused by the c.614T.C mutation in the BEST1 gene
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Maurizio Battaglia Parodi, LiborioLeonardo Mastropasqua, Liborio Stuppia, Ivana Antonucci, Camiel J. F. Boon, Lisa Toto, Luca Di Antonio, Rodolfo Mastropasqua, Toto, Lisa, Boon, Camiel J. F., Di Antonio, Luca, Parodi, Maurizio Battaglia, Mastropasqua, Rodolfo, Antonucci, Ivana, Stuppia, Liborio, and Mastropasqua, Liborioleonardo
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0301 basic medicine ,Proband ,Male ,Pathology ,genetic structures ,Chloride Channel ,Fundus (eye) ,Bestrophinopathy ,Sensory disorders Donders Center for Medical Neuroscience [Radboudumc 12] ,Retinal Disease ,Microphthalmo ,Macular Degeneration ,0302 clinical medicine ,Microphthalmos ,Bestrophins ,Fluorescein Angiography ,Corneal Dystrophies, Hereditary ,medicine.diagnostic_test ,Eye Diseases, Hereditary ,Exons ,General Medicine ,BEST1 gene ,Middle Aged ,Fluorescein angiography ,Pedigree ,medicine.anatomical_structure ,Hyperopia ,Phenotype ,Female ,Glaucoma, Angle-Closure ,Erg ,Autosomal recessive bestrophinopathy ,Tomography, Optical Coherence ,Human ,Adult ,medicine.medical_specialty ,Exon ,Biology ,03 medical and health sciences ,Young Adult ,Retinal Diseases ,Chloride Channels ,medicine ,Electroretinography ,Humans ,Point Mutation ,Bestrophin ,Eye Proteins ,Aged ,Retinal pigment epithelium ,Autosomal inheritance ,Eye Protein ,Sequence Analysis, DNA ,Macular degeneration ,medicine.disease ,eye diseases ,Electrooculography ,Ophthalmology ,030104 developmental biology ,030221 ophthalmology & optometry ,sense organs - Abstract
Item does not contain fulltext PURPOSE: To describe the variable ocular phenotype associated with a heterozygous mutation in the BEST1 gene. METHODS: Clinical and genetic assessment was performed in five members of the same family. Molecular genetic analysis of the BEST1 gene was performed by direct sequencing. Extensive ophthalmic examination included color fundus imaging, spectral domain optical coherence tomography, fundus autofluorescence, electro-oculography (EOG), and full-field electroretinography (ERG). The main outcome measures were BEST1 mutations, imaging, and electroretinography findings. RESULTS: All affected family members carried a single heterozygous c.614T>C (p.I205T) mutation in exon 5 of the BEST1 gene. The 46-year-old proband showed nanophthalmos with chorioretinal atrophy in the macula, extensive coarse hyperpigmentation in the (mid) peripheral retina with tractional vitreous strands. Full-field ERG revealed nonrecordable cone and rod responses, and EOG showed an absent light rise. The daughter and son of the proband showed a phenotype resembling autosomal recessive bestrophinopathy, including short axial lengths, cystoid fluid collections, and shallow serous subretinal fluid accumulation on spectral domain optical coherence tomography throughout the macula in combination with mild retinal pigment epithelium changes. The son of the proband also showed subretinal yellowish deposits inferiorly in the macula as well as outside the temporal vascular arcade, that were hyperfluorescent on fundus autofluorescence, similar to those seen in autosomal recessive bestrophinopathy. Full-field ERG revealed a reduced rod and cone response and a markedly reduced or absent EOG light peak in both brother and sister of the proband. CONCLUSION: The clinical spectrum of bestrophinopathy may encompass severe ocular phenotypes that affect the development and function of the entire eye. A clinical picture similar to autosomal recessive bestrophinopathy can also be caused by a single heterozygous mutation in the BEST1 gene, such as the c.614T>C (p.I205T) variant in this family.
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- 2016
184. Retinal Changes Induced by Epiretinal Tangential Forces
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Mario R. Romano, Gilda Cennamo, Stefano De Cillà, Giovanni Cennamo, Chiara Comune, Lisa Toto, Mariantonia Ferrara, Romano, Mario, Comune, Chiara, Ferrara, Mariantonia, Cennamo, Gilda, De Cillà, Stefano, Toto, Lisa, and Cennamo, Giovanni
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Retina ,medicine.medical_specialty ,genetic structures ,business.industry ,Vitreoschisis ,Retinal ,Review Article ,Adhesion ,medicine.disease ,Posterior vitreous detachment ,eye diseases ,Ophthalmology ,chemistry.chemical_compound ,Synchysis ,medicine.anatomical_structure ,chemistry ,lcsh:Ophthalmology ,lcsh:RE1-994 ,medicine ,Vitreoretinal traction ,sense organs ,business - 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.
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- 2015
185. Qualitative and Quantitative Assessment of Vascular Changes in Diabetic Macular Edema after Dexamethasone Implant Using Optical Coherence Tomography Angiography
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Marco Ciancaglini, Daniele Tognetto, Leonardo Mastropasqua, Rossella D'Aloisio, Lisa Toto, Giuseppe Di Martino, Silvio Di Staso, Marta Di Nicola, Toto, Lisa, D'Aloisio, Rossella, Di Nicola, Marta, DI MARTINO, Giuseppe, Di Staso, Silvio, Ciancaglini, Marco, Tognetto, Daniele, and Mastropasqua, Leonardo
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Male ,0301 basic medicine ,genetic structures ,optical coherence tomography angiography ,Dexamethasone ,chemistry.chemical_compound ,Drug Delivery Systems ,0302 clinical medicine ,Diabetic macular edema ,Diabetic retinopathy ,Intravitreal dexamethasone implant ,Optical coherence tomography angiography ,Catalysis ,Molecular Biology ,Computer Science Applications1707 Computer Vision and Pattern Recognition ,Spectroscopy ,Physical and Theoretical Chemistry ,Organic Chemistry ,Inorganic Chemistry ,medicine.diagnostic_test ,Angiography ,General Medicine ,Middle Aged ,Computer Science Applications ,diabetic retinopathy ,medicine.anatomical_structure ,Female ,diabetic macular edema ,Tomography, Optical Coherence ,Optic disc ,medicine.drug ,medicine.medical_specialty ,Article ,Macular Edema ,Retina ,intravitreal dexamethasone implant ,03 medical and health sciences ,Ophthalmology ,medicine ,Humans ,Glucocorticoids ,Macular edema ,Aged ,Diabetic Retinopathy ,business.industry ,Retinal Vessels ,Retinal ,medicine.disease ,eye diseases ,Surgery ,030104 developmental biology ,Diabetes Mellitus, Type 2 ,chemistry ,030221 ophthalmology & optometry ,sense organs ,Implant ,business - Abstract
The aim of this study was to investigate retinal and choriocapillaris vessel changes in diabetic macular edema (DME) after the intravitreal dexamethasone implant (IDI) using optical coherence tomography angiography (OCTA). Moreover, a comparison between morphological and functional parameters of DME and healthy patients was performed. Twenty-five eyes of 25 type 2 diabetic retinopathy patients complicated by macular edema (DME group) and 25 healthy subjects (control group) were enrolled. Superficial capillary plexus density (SCPD) and deep capillary plexus density (DCPD) in the foveal and parafoveal areas, choricapillary density (CCD) and optic disc vessel density (ODVD) were detected using OCTA at baseline and after 7, 30, 60, 90 and 120 days post injection. Best corrected visual acuity (BCVA), retinal sensitivity, and central retinal thickness (CMT) were also evaluated in both groups of patients. A statistically significant difference between the two groups (DME and controls) was found in terms of functional (MP, p < 0.001 and BCVA, p < 0.001) and morphological (CMT, p < 0.001; SCPD in the parafoveal area, p < 0.001; DCPD in the foveal area, p < 0.05 and parafoveal area, p < 0.001; CCD, p < 0.001) parameters. After the treatment, SCPD and DCPD in the foveal and parafoveal areas did not modify significantly during the follow up.
- Published
- 2017
186. A deep learning approach to hard exudates detection and disorganization of retinal inner layers identification on OCT images.
- Author
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Toto L, Romano A, Pavan M, Degl'Innocenti D, Olivotto V, Formenti F, Viggiano P, Midena E, and Mastropasqua R
- Subjects
- Humans, Neural Networks, Computer, Image Processing, Computer-Assisted methods, Tomography, Optical Coherence methods, Deep Learning, Diabetic Retinopathy diagnostic imaging, Diabetic Retinopathy pathology, Macular Edema diagnostic imaging, Exudates and Transudates diagnostic imaging, Retina diagnostic imaging, Retina pathology
- Abstract
The purpose of the study was to detect Hard Exudates (HE) and classify Disorganization of Retinal Inner Layers (DRIL) implementing a Deep Learning (DL) system on optical coherence tomography (OCT) images of eyes with diabetic macular edema (DME). We collected a dataset composed of 442 OCT images on which we annotated 6847 HE and the presence of DRIL. A complex operational pipeline was defined to implement data cleaning and image transformations, and train two DL models. The state-of-the-art neural network architectures (Yolov7, ConvNeXt, RegNetX) and advanced techniques were exploited to aggregate the results (Ensemble learning, Edge detection) and obtain a final model. The DL approach reached good performance in detecting HE and classifying DRIL. Regarding HE detection the model got an AP@0.5 score equal to 34.4% with Precision of 48.7% and Recall of 43.1%; while for DRIL classification an Accuracy of 91.1% with Sensitivity and Specificity both of 91.1% and AUC and AUPR values equal to 91% were obtained. The P-value was lower than 0.05 and the Kappa coefficient was 0.82. The DL models proved to be able to identify HE and DRIL in eyes with DME with a very good accuracy and all the metrics calculated confirmed the system performance. Our DL approach demonstrated to be a good candidate as a supporting tool for ophthalmologists in OCT images analysis., (© 2024. The Author(s).)
- Published
- 2024
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- View/download PDF
187. A case of accidental into-the-lens dexamethasone implant: watching or removing?
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Ruggeri ML, Quarta A, D'Aloisio R, Toto L, and Mastropasqua R
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- Humans, Male, Aged, 80 and over, Lens, Crystalline surgery, Macular Edema drug therapy, Macular Edema etiology, Macular Edema diagnosis, Phacoemulsification, Lens Implantation, Intraocular adverse effects, Visual Acuity, Intravitreal Injections, Dexamethasone administration & dosage, Glucocorticoids administration & dosage, Drug Implants adverse effects
- Abstract
Background: To report a case of cataract surgery in unintentional Ozurdex (Allergan, Inc., Irvine, California, USA) injection into the lens., Case Presentation: A 82-years old man reporting decreased visual acuity in his right eye came to our Ophthalmology service. Due to the clinical history, and on the basis of ophthalmoscopic and imaging examinations diabetic macular edema was diagnosed. Thus, intravitreal dexamethasone implant was scheduled and therefore performed. The following day Ozurdex appeared to be located into the lens. After careful evaluation and strict follow up examinations, due to the risks associated with the presence of the implant into the lens, phacoemulsification with Ozurdex removal and intraocular lens (IOL) implantation was scheduled and performed., Conclusions: In this case report we reported the surgical management of accidental into-the lens dexamethasone implant carefully taking into account the dexamethasone pharmacokinetic., (© 2024. The Author(s).)
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- 2024
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- View/download PDF
188. Effect of Pro Re Nata Regimen with Anti-VEGF on Type 3 Macular Neovascularization: Long-Term Outcomes.
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Toto L, Viggiano P, Quarta A, Grassi M, De Nicola C, Aloia R, D'Aloisio R, Boscia G, Boscia F, Porreca A, Di Nicola M, Savastano MC, and Mastropasqua R
- Subjects
- Humans, Retrospective Studies, Male, Female, Aged, Follow-Up Studies, Aged, 80 and over, Macula Lutea pathology, Bevacizumab administration & dosage, Treatment Outcome, Wet Macular Degeneration drug therapy, Wet Macular Degeneration diagnosis, Wet Macular Degeneration physiopathology, Fundus Oculi, Time Factors, Middle Aged, Angiogenesis Inhibitors administration & dosage, Intravitreal Injections, Visual Acuity, Vascular Endothelial Growth Factor A antagonists & inhibitors, Tomography, Optical Coherence methods, Ranibizumab administration & dosage, Fluorescein Angiography methods
- Abstract
Introduction: The purpose of this study was to investigate long-term outcomes of intravitreal injections (IVI) of antivascular endothelial growth factor (VEGF) in neovascular age-related macular degeneration (nAMD) with type 3 macular neovascularization (MNV)., Methods: This retrospective study included 19 eyes of 17 patients with nAMD and type 3 MNV treated with anti-VEGF IVI with a loading dose and a PRN regimen. Best corrected visual acuity (BCVA), central macular thickness (CMT), presence of macular intraretinal fluid (IRF) and subretinal fluid (SRF), flow area (FA), subfoveal choroidal thickness (CT), and macular atrophy (MA) were assessed at baseline (T0) and during follow-up (T1, post-loading phase; T2, 1 year; T3, 2 years; T4 >2 years). The correlations between MA at the last follow-up and standard deviation (SD) values of CMT and CT during follow-up were assessed. The influence of the number of injections on the change in MA over time was also analyzed. MA differences at T4 were assessed for pseudodrusen presence., Results: BCVA improved significantly during follow-up (p = 0.013) particularly increasing from baseline to post-loading phase and then did not modify significantly thereafter. CMT significantly reduced from T0 to T1 and remained stable during follow-up (p = <0.001). MNV flow area showed a trend toward an increase in the post-loading phase that was not statistically significant (p = 0.082) and CT decreased significantly during follow-up (p < 0.001). MA changed significantly during follow-up (p < 0.001) with a significant increase from T0 to T3 and from T0 to T4 (p < 0.010). A Cochran-Armitage test for trend showed a significant reduction (p = 0.001) of macular IRF and SRF during follow-up. MA at T4 showed a significant positive correlation with SD (standard deviation) values of CMT (p = 0.040) and CT (p = 0.020). Indeed, the number of injections did not influence the change over time of MA (p = 0.709). MA at T4 was not statistically significantly different between patients with pseudodrusen at baseline (p = 0.497)., Conclusions: Intravitreal anti-VEGF injections with PRN regimen in MNV type 3 showed functional and anatomical benefits. Variations of retinal thickness and choroidal thickness during treatment were related to MA modification over time., (© 2024 The Author(s). Published by S. Karger AG, Basel.)
- Published
- 2024
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- View/download PDF
189. Choroidal Vascularity Index Fluctuations in Epiretinal Membranes in Vitreoretinal Surgery: Comparison Between Idiopathic and Diabetic Ones.
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D'Aloisio R, Ruggeri ML, Porreca A, Di Nicola M, Aharrh-Gnama A, Quarta A, Gironi M, Toto L, and Mastropasqua R
- Subjects
- Humans, Prospective Studies, Tomography, Optical Coherence, Visual Acuity, Epiretinal Membrane surgery, Vitreoretinal Surgery, Diabetes Mellitus surgery
- Abstract
Purpose: The aim of the study was to analyze choroidal vascularity index (CVI) fluctuations in patients with epiretinal membrane after vitreoretinal surgery, comparing idiopathic and secondary diabetic ones., Methods: Thirty eyes suffering from idiopathic ERMs (I-ERMS; n = 15) and diabetic ERMs (D-ERMS; n = 15) were analyzed in this observational prospective study. Anatomical (central macular thickness) and functional (best-corrected visual acuity) parameters were analyzed preoperatively and at 1 and 3 months after vitrectomy. Perfusion findings regarding CVI and luminal area were also calculated., Results: At 1 month after surgery, the luminal area and CVI significantly decreased in the I-ERMS group, whereas they were increased in the D-ERMS group. At the 3-month follow-up, the CVI tended to return to baseline values in I-ERMS and to reduce in D-ERMS, but without any statistical differences., Conclusions: The significant change in the CVI after surgery seems to imply that the choroidal layer is affected by vitreomacular disease and can become a novel potential biomarker of predictiveness in vitreoretinal surgery., Translational Relevance: The aim of the study was to focus on the early choroidal changes to better understand initial predictive elements of long-term functional postoperative outcomes.
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- 2023
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190. Choroidal modifications assessed by means of choroidal vascularity index after oral eplerenone treatment in chronic central serous chorioretinopathy.
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Toto L, Ruggeri ML, Evangelista F, Viggiano P, D'Aloisio R, De Nicola C, Falconio G, Di Nicola M, Porreca A, and Mastropasqua R
- Subjects
- Humans, Eplerenone therapeutic use, Retrospective Studies, Chronic Disease, Choroid, Tomography, Optical Coherence methods, Central Serous Chorioretinopathy diagnosis, Central Serous Chorioretinopathy drug therapy
- Abstract
Background: To investigate choroidal vascularity index (CVI) changes after oral eplerenone treatment in chronic central serous chorioretinopathy (cCSC) using the Spectral-domain (SD)-Optical Coherence Tomography (OCT) with enhanced depth imaging (EDI) mode., Methods: Thirty-six eyes of 18 patients suffering from cCSC with monolateral foveal subretinal fluid (FSRF) successfully treated with oral eplerenone treatment and 18 age-matched healthy subjects were enroled in this retrospective study. EDI-OCT images obtained using Heidelberg Spectralis OCT device in patients with cCSC and FSRF (group 1); fellow eye (group 2) or healthy patients (healthy) were exported and then imported into image analysis ImageJ software for subsequent quantitative analysis. The main outcome measures were luminal area (LA) and CVI., Results: A higher value of CVI was detected in group 1 compared to healthy eyes (p = 0.006). LA and CVI significantly reduced during follow up in group 1 and group 2. LA at 120 days was significantly lower compared to all previous time points both in group 1 and group 2 (p < 0.001). Median and [1st -3rd quartile] CVI values were 0.8 [0.7; 1.1] at baseline, 0.8 [0.7; 0.9] at 30 days; 0.7 [0.6; 0.9] at 60 and 90 days and 0.6 [0.5; 0.8] at 120 days in group 1 (p = 0.007) and 0.7 [0.6; 0.9] at baseline, 0.7 [0.7; 0.8] at 30 days; 0.7 [0.6; 0.7] at 60 and 90 days and 0.6 [0.6; 0.7] at 120 days in group 2 (p = 0.018)., Conclusions: Choroidal vascularity index reduced in cCSC patients after oral eplerenone treatment during follow up both in eyes with SRF and fellow eyes thus demonstrating the effectiveness of mineral corticoid receptor antagonists in recovering choroidal morphology., (© 2022. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)
- Published
- 2023
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- View/download PDF
191. Validation of an Automated Artificial Intelligence Algorithm for the Quantification of Major OCT Parameters in Diabetic Macular Edema.
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Midena E, Toto L, Frizziero L, Covello G, Torresin T, Midena G, Danieli L, Pilotto E, Figus M, Mariotti C, and Lupidi M
- Abstract
Artificial intelligence (AI) and deep learning (DL)-based systems have gained wide interest in macular disorders, including diabetic macular edema (DME). This paper aims to validate an AI algorithm for identifying and quantifying different major optical coherence tomography (OCT) biomarkers in DME eyes by comparing the algorithm to human expert manual examination. Intraretinal (IRF) and subretinal fluid (SRF) detection and volumes, external limiting-membrane (ELM) and ellipsoid zone (EZ) integrity, and hyperreflective retina foci (HRF) quantification were analyzed. Three-hundred three DME eyes were included. The mean central subfield thickness was 386.5 ± 130.2 µm. IRF was present in all eyes and confirmed by AI software. The agreement (kappa value) (95% confidence interval) for SRF presence and ELM and EZ interruption were 0.831 (0.738-0.924), 0.934 (0.886-0.982), and 0.936 (0.894-0.977), respectively. The accuracy of the automatic quantification of IRF, SRF, ELM, and EZ ranged between 94.7% and 95.7%, while accuracy of quality parameters ranged between 99.0% (OCT layer segmentation) and 100.0% (fovea centering). The Intraclass Correlation Coefficient between clinical and automated HRF count was excellent (0.97). This AI algorithm provides a reliable and reproducible assessment of the most relevant OCT biomarkers in DME. It may allow clinicians to routinely identify and quantify these parameters, offering an objective way of diagnosing and following DME eyes.
- Published
- 2023
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- View/download PDF
192. Choroidal and Retinal Imaging Biomarkers in Different Types of Macular Neovascularization.
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Toto L, Ruggeri ML, Evangelista F, Trivigno C, D'Aloisio R, De Nicola C, Viggiano P, Doronzo E, Di Nicola M, Porreca A, and Mastropasqua R
- Abstract
Background: The aim of this study was to investigate optical coherence tomography (OCT) and OCT angiography (OCTA) parameters in patients with neovascular age-related macular degeneration (nAMD) and macular neovascularization (MNV) type 1, type 2, and type 3., Methods: In this retrospective study, 105 treatment-naïve eyes of 105 patients (60 men and 45 women) with a definite diagnosis of active nAMD and MNV of different types and 105 frequency-matched age and gender healthy subjects were evaluated (61 men and 44 women). All subjects underwent a full ophthalmic examination and multimodal imaging assessment, including spectral domain (SD) OCT and OCTA. The main outcome measures were choroidal vascularity index (CVI), subfoveal choroidal thickness (SFCT), central macular thickness (CMT), and outer retina to choriocapillaris (ORCC) MNV flow area (ORCCFA)., Results: Significant differences were found in terms of CVI, CMT, and ORCCFA between MNV 1 and the two other groups. CVI was significantly different between MNV 1 and healthy control patients ( p < 0.001) and between MNV 1 and MNV 2 ( p < 0.001). ORCCFA and CMT were significantly different between MNV1 and MNV2 ( p < 0.005). The difference in subfoveal CT between the three groups was not statistically significant ( p = 0.458). A significant negative correlation was found between CVI and ORCCFA. Furthermore, CVI showed a positive correlation with subfoveal CT.
- Published
- 2023
- Full Text
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193. Study of Nonperfusion Area Changes after Ranibizumab Intravitreal Injection for Diabetic Macular Edema by Means of Widefield OCT Angiography.
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Toto L, D'Aloisio R, Libertini D, D'Onofrio G, De Nicola C, Mastropasqua R, and Chiarelli AM
- Subjects
- Humans, Ranibizumab therapeutic use, Tomography, Optical Coherence methods, Intravitreal Injections, Fluorescein Angiography methods, Retinal Vessels, Retrospective Studies, Diabetic Retinopathy complications, Diabetic Retinopathy diagnosis, Diabetic Retinopathy drug therapy, Macular Edema diagnosis, Macular Edema drug therapy, Macular Edema etiology, Diabetes Mellitus drug therapy
- Abstract
Introduction: The aim of this study was to evaluate changes in retinal capillary nonperfusion areas (RCNPA) and the retinal capillary vessel density (RCVD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) using widefield optical coherence tomography angiography (WFOCTA) in patients with diabetic retinopathy (DR) and diabetic macular edema (DME) treated with intravitreal ranibizumab injection (IRI)., Materials and Methods: Twenty-four eyes of 24 patients with DR and DME candidates to a loading dose of IRI were enrolled. All patients underwent WFOCTA with the PLEX Elite 9000 device with 15 × 9 mm scans centered on the foveal center at baseline (T0) and 1 month after each intravitreal injection at 30 days (T1), 60 days (T2), and 90 days (T3). In all patients, the variation of RCNPA and the RCVD of the SCP and DCP were calculated using automatic software written in MATLAB (MathWorks, Natick, MA, USA)., Results: The SCP showed a significant longitudinal variation of RCNPA (p = 0.04). Post hoc analysis revealed a statistically significant reduction of RCNPA at T1 (p = 0.04) and a nonsignificant reduction at T2 (p = 0.18) and T3 (p = 0.96). The DCP showed longitudinal changes in the RCNPA that tended to statistical significance (p = 0.09). Post hoc analysis revealed a trend toward a statistically significant reduction of RCNPA at T3 (p = 0.09) not statistically significant at T1 (p = 0.17) and T2 (p = 0.75). The RCVD of SCP and DCP showed no significant changes at any of the time points., Conclusions: WFOCTA showed a decrease in RCNPA after IRI, probably related to the reperfusion of retinal capillaries., (© 2022 The Author(s). Published by S. Karger AG, Basel.)
- Published
- 2023
- Full Text
- View/download PDF
194. Long-Term Follow-Up of Brolucizumab in Macular Neovascularization.
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Ruggeri ML, Toto L, D'Aloisio R, Quarta A, Aloia R, Venturoni P, De Nicola C, Doronzo E, Gironi M, Porreca A, Di Nicola M, and Mastropasqua R
- Subjects
- Humans, Angiogenesis Inhibitors therapeutic use, Follow-Up Studies, Antibodies, Monoclonal, Humanized, Tomography, Optical Coherence methods, Atrophy drug therapy, Intravitreal Injections, Retrospective Studies, Retinal Neovascularization, Wet Macular Degeneration drug therapy
- Abstract
Introduction: The aim of the study was to evaluate functional and anatomical changes in type 1 and type 2 naïve macular neovascularization (MNV) patients treated with brolucizumab injections up to 1 year of treatment (week 48)., Methods: Thirty-eight eyes of 38 patients with active MNV were enrolled at the Ophthalmology Clinic of the University "G. d'Annunzio," Chieti-Pescara, Italy. All patients were scheduled for brolucizumab intravitreal injections as per label, according to the standard HAWK and HARRIER trials guidelines. Enrolled patients underwent complete ophthalmic evaluation, including optical coherence tomography (OCT) and OCT angiography. All measurements were evaluated at baseline and then monthly up to week 48. The main outcome measures were changes in best-corrected visual acuity (BCVA); central macular thickness (CMT); subfoveal choroidal thickness (SCT); pigment epithelial detachment presence and maximum height (PEDMH); intraretinal fluid (IRF) presence, subfoveal subretinal fluid (SSRF) presence and maximum height, macular atrophy area, and neovascular membrane flow area in the slab extending from the outer retina to choriocapillaris (ORCC flow)., Results: CMT and BCVA significantly changed in both groups over time. ORCC flow and SCT significantly reduced in both groups over time. Atrophy areas increased from 0 to 0.17 mm2 and from 0 to 0.23 mm2 in type 1 MNV and type 2 MNV patients, respectively. PEDMH reduced in type 1 MNV from 138 μm at T0 to 96 μm at T5. Changes in fluids were noted, with SSRF thickness reduction and IRF changes in both groups., Conclusion: Our one-year results of treatment confirm brolucizumab to be efficient and safe in both type 1 and type 2 MNV patients, proposing novel OCT parameters as possible biomarkers of treatment., (© 2023 The Author(s). Published by S. Karger AG, Basel.)
- Published
- 2023
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195. Brolucizumab Intravitreal Injection in Macular Neovascularization Type 1: VA, SD-OCT, and OCTA Parameter Changes during a 16-Week Follow-Up.
- Author
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Toto L, Ruggeri ML, D'Aloisio R, De Nicola C, Trivigno C, Cerino L, Di Marzio G, Di Nicola M, Porreca A, and Mastropasqua R
- Subjects
- Humans, Angiogenesis Inhibitors therapeutic use, Follow-Up Studies, Tomography, Optical Coherence, Intravitreal Injections, Prospective Studies, Macular Degeneration drug therapy, Choroidal Neovascularization diagnosis, Choroidal Neovascularization drug therapy, Retinal Detachment
- Abstract
Introduction: The aim of this study was to assess early anatomical and functional changes after brolucizumab intravitreal injection (BIVI) in patients with age-related macular degeneration (AMD) and macular neovascularization type 1 (MNV1)., Methods: A total of 24 eyes of 24 patients suffering from naïve AMD with MNV1 candidates to BIVI as per label with q12/q8 dosing regimen after the loading dose were enrolled in this prospective study. Main outcome measures during a 16-week follow-up period included changes in best corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal subretinal fluid (SSRF) thickness (SSRFT), subfoveal sub-retinal pigment epithelium (RPE) fluid thickness (SSRPEFT), subfoveal choroidal thickness (SFCT), and pigment epithelial detachment (PED) maximum height (PED-MH). In addition, MNV1 flow area; percentages of eyes with intraretinal fluid (IRF), subretinal fluid, and sub-RPE fluid at different time points; and percentages of eyes candidates to a q8 or q12 injection interval after disease activity assessment at week 16 were evaluated., Results: BCVA improved significantly from baseline (T0) to week 12 (T3) (p = 0.028). CMT showed a significant reduction from 456 ± 123 µm at T0 to 265 ± 85 µm at T3 (p < 0.001). SSRFT and SSRPEFT reduced significantly as well (p < 0.001 and p = 0.049, respectively). PED-MH and SFCT reduced significantly at the different time points (p = 0.020; p = 0.006, respectively). IRF presence changed significantly from 41.7% of eyes at T0 to 20.8% at T3 (p = 0.045). SSRF reduced significantly during follow-up, being present in 62.5% of eyes at T0 and 4.2% of eyes at T3 (p < 0.001). Subfoveal sub-RPE fluid decreased significantly during time, being present in 20.8% of eyes at T0 and 0% at T3 (p = 0.013). Most of the eyes (18 eyes, 75%) at week 16 after disease activity assessment were shifted in the q12 interval, and only a minority of eyes shifted in a q8 interval (6 eyes, 25%)., Conclusion: Brolucizumab is efficient in AMD patients with MNV1 by reducing all retinal fluids during the loading phase and shows reduction of macular thickness, choroidal thickness, and PED height. Most eyes at disease activity assessment (75%) fall into 12-week interval and the minority (25%) into the 8-week interval., (© 2022 The Author(s). Published by S. Karger AG, Basel.)
- Published
- 2023
- Full Text
- View/download PDF
196. Intravitreal Dexamethasone Implant (IDI) Alone and Combined with Navigated 577 nm Subthreshold Micropulse Laser (SML) for Diabetic Macular Oedema.
- Author
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Toto L, D'Aloisio R, Quarta A, Libertini D, D'Onofrio G, De Nicola C, Romano A, and Mastropasqua R
- Abstract
Background: The anatomical and functional changes after intravitreal dexamethasone implant (IDI) alone and combined with navigated subthreshold micropulse laser (NSML) in diabetic macular oedema (DMO) were compared., Methods: Patients with a clinically confirmed diagnosis of non-proliferative diabetic retinopathy (NPDR) and DMO were enrolled in this prospective study and were randomly assigned to two different treatment groups: thirty patients were treated with IDI (IDI group), and the other 30 patients received IDI combined with NSML treatment (combined IDI/NSML group). All patients during a 6-month follow-up underwent best corrected visual acuity (BCVA) evaluation and spectral domain optical coherence tomography (SD OCT). The main outcome measures were: BCVA, central macular thickness (CMT); (3) choroidal vascularity index (CVI), subfoveal choroidal thickness (SCHT); and time to retreatment between IDI at baseline and the second implant in both groups., Results: BCVA, CMT, and SCHT significantly decreased starting from the 1-month follow-up and CVI from 3 months in both groups. The between-group differences were significantly different from 1-month follow-up for BCVA, from 5-month follow-up for CMT and SCHT, and from 4-month follow-up for CVI. The Needed to Treat analysis indicated that six patients would have to be treated with SML after IDI in order for just one person to receive a benefit., Conclusions: the combined treatment showed good anatomical and functional outcomes for the treatment of DMO. In addition, IDI/SML seems to reduce injection frequency over time, improving patients' quality of life and reducing the socio-economic burden.
- Published
- 2022
- Full Text
- View/download PDF
197. Longitudinal assessment of type 3 macular neovascularization using 3D volume-rendering OCTA.
- Author
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Borrelli E, Mastropasqua L, Souied E, Sadda S, Vella G, Toto L, Miere A, Corradetti G, Sacconi R, Ferro G, Sarraf D, Querques L, Mastropasqua R, Bandello F, and Querques G
- Subjects
- Angiogenesis Inhibitors therapeutic use, Female, Fluorescein Angiography methods, Humans, Intravitreal Injections, Retrospective Studies, Tomography, Optical Coherence methods, Visual Acuity, Choroidal Neovascularization complications, Choroidal Neovascularization diagnosis, Choroidal Neovascularization drug therapy, Macular Degeneration complications, Wet Macular Degeneration complications, Wet Macular Degeneration diagnosis, Wet Macular Degeneration drug therapy
- Abstract
Objective: To investigate the evolution of treatment-naive type 3 macular neovascularization (MNV) undergoing anti-vascular endothelial growth factor (VEGF) treatment through volume rendered three-dimensional (3D) optical coherence tomography angiography (OCTA)., Design: Retrospective observational study., Participants: Patients with type 3 MNV and age-related macular degeneration (AMD)., Methods: Included subjects had three loading injections of an anti-VEGF agent. The OCTA volume data at baseline and follow-up were processed with a previously published algorithm in order to obtain a volume-rendered representation of type 3 MNV. Progressive changes in type 3 lesions were analyzed via 3D OCTA volume rendering., Results: A total of 14 treatment-naive eyes with type 3 MNV from 11 AMD patients (7 females) were included. At both baseline and follow-up visits, a type 3 MNV complex was identifiable. Each complex was composed of a mean number of 2.5 ± 0.7 vascular branches at baseline and 1.4 ± 0.6 at the follow-up visit (p < 0.0001). The mean changes in central macular thickness and visual acuity were significantly correlated with modifications in the number of type 3 MNV branches (ρ = -0.533, p = 0.049, and ρ = -0.581, and p = 0.040, respectively)., Conclusions: This study demonstrated that type 3 lesions do not disappear completely after loading treatment, as indicated previously by histopathologic studies. Importantly, quantitative volume changes in type 3 lesions are directly associated with treatment response., (Copyright © 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
198. Short-term comparison between navigated subthreshold microsecond pulse laser and oral eplerenone for chronic central serous chorioretinopathy.
- Author
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Toto L, D'Aloisio R, De Nicola C, Evangelista F, Ruggeri ML, Cerino L, Simonelli MB, Aharrh-Gnama A, Di Nicola M, Porreca A, and Mastropasqua R
- Subjects
- Chronic Disease, Eplerenone, Fluorescein Angiography, Humans, Lasers, Retina, Retrospective Studies, Tomography, Optical Coherence, Treatment Outcome, Central Serous Chorioretinopathy drug therapy, Central Serous Chorioretinopathy surgery
- Abstract
To compare the anatomical/functional changes after navigated subthreshold pulse laser (SML) and oral eplerenone therapy for chronic central serous chorioretinopathy (cCSC). A total of 36 eyes of 36 patients suffering from cCSC treated with navigated SML (Navilas® 577s; OD-OS GmbH, near Berlin, Germany) (18 eyes, SML group) and oral eplerenone (18 eyes, eplerenone group) were enrolled in this retrospective study. Main outcome measures during a 3-month follow up period included changes of best corrected visual acuity (BCVA), central macular thickness (CMT), foveal subretinal fluid thickness (FSRFT), and subfoveal choroidal thickness (SFCT). At baseline average duration of symptoms was 6.8 ± 0.6 months in SML group and 6.4 ± 0.9 months in eplerenone group (p = 0.127). Mean BCVA, CMT and FSRFT changed significantly over time (p < 0.001). From baseline to 90 days the BCVA improved from 0.3 ± 0.1 to 0.1 ± 0.1 logMAR in SML group and from 0.3 ± 0. to 0.2 ± 0.1 logMAR in eplerenone group, CMT reduced from 357.1 ± 104.3 to 210.6 ± 46.7 μm and from 428.7 ± 107.7 to 332.5 ± 27.5 μm in SML group and eplerenone group respectively, FSRFT reduced from 144.4 ± 108.2 to 22.6 ± 37.2 μm and from 217.1 ± 105.9 to 54.4 ± 86.2 μm in SML group and eplerenone group. 55.6% of patients in SML group and 66.7% in eplerenone group showed a complete resolution of FSRFT during follow up. The interaction between group and time was statistically significant with greater absolute variation for CMT and FSRFT in SML group compared to eplerenone group (p < 0.001 and p = 0.043). SFCT did not change significantly during follow up (p = 0.083) for both groups. Both navigated SML and oral eplerenone were effective treatments showing recovery of retinal morphology and related visual acuity improvement in cCSC., (© 2022. The Author(s).)
- Published
- 2022
- Full Text
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199. Is there a gold standard to assess haemodynamic retina perfusion?
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Neri G and Toto L
- Subjects
- Humans, Perfusion, Hemodynamics, Retina diagnostic imaging
- Published
- 2021
- Full Text
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200. Transcriptomic analysis revealed increased expression of genes involved in keratinization in the tears of COVID-19 patients.
- Author
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Mastropasqua L, Toto L, Chiricosta L, Diomede F, Gugliandolo A, Silvestro S, Marconi GD, Sinjari B, Vecchiet J, Cipollone F, D'Ardes D, Auricchio A, Lanzini M, Caputi S, D'Aloisio R, Mazzon E, and Trubiani O
- Subjects
- Aged, B-Lymphocytes metabolism, COVID-19 pathology, COVID-19 virology, Eye Diseases genetics, Female, High-Throughput Nucleotide Sequencing methods, Humans, Keratins metabolism, Male, SARS-CoV-2 isolation & purification, Sequence Analysis, RNA methods, Skin metabolism, Skin pathology, Skin virology, Tears virology, COVID-19 genetics, Eye Diseases virology, Tears metabolism, Transcriptome
- Abstract
Recent studies have focused their attention on conjunctivitis as one of the symptoms of coronavirus disease 2019 (COVID-19). Therefore, tear samples were taken from COVID-19 patients and the presence of SARS-CoV-2 was evidenced using Real Time reverse transcription polymerase chain reaction. The main aim of this study was to analyze mRNA expression in the tears of patients with COVID-19 compared with healthy subjects using Next Generation Sequencing (NGS). The functional evaluation of the transcriptome highlighted 25 genes that differ statistically between healthy individuals and patients affected by COVID-19. In particular, the NGS analysis identified the presence of several genes involved in B cell signaling and keratinization. In particular, the genes involved in B cell signaling were downregulated in the tears of COVID-19 patients, while those involved in keratinization were upregulated. The results indicated that SARS-CoV-2 may induce a process of ocular keratinization and a defective B cell response., (© 2021. The Author(s).)
- Published
- 2021
- Full Text
- View/download PDF
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