456 results on '"Mario R Romano"'
Search Results
2. Effectiveness of a Hydrophilic Curcumin-Based Formulation in Coadjuvating the Therapeutic Effect of Intravitreal Dexamethasone in Subjects With Diabetic Macular Edema
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Mariacristina Parravano, Davide Allegrini, Adriano Carnevali, Eliana Costanzo, Giuseppe Giannaccare, Paola Giorno, Vincenzo Scorcia, Giorgio Alfredo Spedicato, Monica Varano, and Mario R Romano
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diabetic macular edema ,dexamethasone ,curcumin in hydrophilic carrier ,CurcuWIN ,central retinal thickness ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Purpose: This study evaluates if the addition of a curcumin formulation with a polyvinylpyrrolidone-hydrophilic carrier (CHC; Diabec®, Alfa Intes, Italy) to intravitreal injections of dexamethasone (DEX-IVT) can affect the morphological retinal characteristics, extending the steroid re-treatment period in patients with diabetic macular edema (DME).Methods: A randomized controlled clinical trial was carried out in DME patients, randomly assigned to receive DEX-IVT or DEX-IVT and a CHC. The evaluation of the mean difference of central retinal thickness (CRT) was the primary aim. Secondary aims were the evaluations of best-corrected visual acuity, differences in the predetermined retinal layer thickness, the number/time of re-treatment, and the assessment of safety.Results: A total of 73 DME patients were included (35 in the control group and 38 in the combined therapy group). In both the control and combined therapy groups, the mean CRT change from T0 to the 6 months’ evaluation was significant (p = 0.00). The mean CRT result was significantly different at month 4 (p = 0.01) between the control and combined therapy groups, with a greater reduction in the combined therapy group, in particular, in patients with ≤10 years of diabetes. A trend of CRT reduction in the combined therapy group has been observed also considering patients with subfoveal neuroretinal detachment. In addition, we observed that the reduction of inner retinal layer thickness was greater in the combination group, in comparison with controls.Conclusion: The combination of a CHC to DEX-IVT is a promising therapeutic option in case of DME, in particular, for patients with early-stage diabetes and with an inflammatory phenotype. Further studies will be necessary to confirm these findings.
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- 2022
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3. A novel quantitative analysis method for idiopathic epiretinal membrane.
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Davide Allegrini, Giovanni Montesano, Stefania Marconi, Nicoletta Rosso, Giovanni Ometto, Raffaele Raimondi, Ferdinando Auricchio, Panagiotis Tsoutsanis, Francesco Semeraro, Matteo Cacciatori, David P Crabb, and Mario R Romano
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Medicine ,Science - Abstract
PurposeTo introduce a novel method to quantitively analyse in three dimensions traction forces in a vast area of the ocular posterior pole.MethodsRetrospective analysis of 14 eyes who underwent peeling surgery for idiopathic, symptomatic and progressive epiretinal membrane. The technique measures the shift in position of vascular crossings after surgery from a fixed point, which is the retinal pigmented epithelium. This shift is defined as the relaxation index (RI) and represents a measure of the postoperative movement of the retina due to released traction after surgery.ResultsBest-corrected visual acuity was significantly better than baseline at all follow ups while the RI had its maximum value at baseline. Moreover, we found a significant correlation between best-corrected visual acuity at 6 months and RI at baseline.ConclusionWhile all previous published methods focused on bi-dimensional changes observed in a small region, this study introduces a three-dimensional assessment of tractional forces. Future integration of RI into built-in processing software will allow systematic three-dimensional measurement of intraretinal traction.
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- 2021
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4. Optic nerve compression: the role of the lamina cribrosa and translaminar pressure
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Mario R Romano, Gilda Cennamo, Maria Angelica Breve, Michela Piedepalumbo, Claudio Iovino, Nunzio Velotti, and Giovanni Cennamo
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1888 ,optic nerve compression ,lamina cribrosa ,translaminar pressure ,Ophthalmology ,RE1-994 - Abstract
AIM: To describe the morphological changes of the lamina cribrosa (LC) in patients with optic nerve compression. METHODS: Cross-sectional study. Twenty eyes with optic nerve compression, affected by Graves' ophthalmopathy (GO) were compared with 18 refractive error-matched healthy eyes. The following examinations were performed: best-corrected visual acuity (BCVA), intraocular pressure, optic nerve echography, visual field, SD-OCT including the retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), and LC thickness and extent. RESULTS: A-scan revealed significant differences in the subarachnoid space (SAS) between the affected and control groups. LC thickness and LC area were 233 µm (SD 23) and 0.41 mm2 (SD 0.19), respectively. Average GCC thickness (P=0.0005), LC thickness (P=0.001), MD (P=0.001) and PSD (P=0.001) differed significantly between the two groups; whereas LC area (P=0.2) and average RFNL (P=0.1) did not. CONCLUSION: Optic nerve compression reduces the SAS thereby altering the morphology of LC thickness and causing GCC damage.
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- 2017
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5. Macular Microvascular Modifications in Progressive Lamellar Macular Holes
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Fiammetta Catania, Davide Allegrini, Alessandra Nembri, Filippo Confalonieri, Piero Zollet, Emanuele Crincoli, and Mario R Romano
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lamellar macular hole ,oct angiography ,neurovascular unit ,retinal microvasculature ,Muller cells ,Medicine (General) ,R5-920 - Abstract
Lamellar macular holes (LMHs) may show morphological and functional deterioration over time, yet no definite prognostic factor for progression has been identified. Since neurovascular retinal unit impairment may take part in neurodegeneration, we compare progressive LMHs to stable ones in optical coherence tomography (OCT) angiography parameters. Methods: OCT B scans of eyes with LMH were analyzed to detect the presence of tissue loss (TL) over time, allowing us to identify a TL group and a stable (ST) group (14 patients each). The best corrected visual acuity (BCVA) at each considered imaging time point was collected. Lastly, patients underwent macular OCT angiography. Results: BCVA at last follow up was significantly reduced in the TL group compared to both the ST group and TL group baseline assessment. SCP foveal vessel density (VD), SCP and deep capillary plexus (DCP) perfusion density (PD) and parafoveal PD were lower in the TL group. Linear correlations between quantitative TL over time and parafoveal PD in SCP and between the speed of TL and BCVA variation during follow up were also detected. Conclusions: TL in LMHs is associated with both OCT angiography modifications and BCVA deterioration over time. We suggest these findings to be a manifestation of foveal Muller cell impairment in progressive LMHs.
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- 2021
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6. Optical coherence tomography-angiography of juxtapapillary hamartoma
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Gilda Cennamo, Mario R Romano, Maria Angelica Breve, Nunzio Velotti, Giuseppe de Crecchio, and Giovanni Cennamo
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1330 ,Letter to the Editor ,Ophthalmology ,RE1-994 - Abstract
Letter to the Editor
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- 2017
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7. Intraretinal changes in idiopathic versus diabetic epiretinal membranes after macular peeling.
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Mario R Romano, Gennaro Ilardi, Mariantonia Ferrara, Gilda Cennamo, Davide Allegrini, Pia Clara Pafundi, Ciro Costagliola, Stefania Staibano, and Giovanni Cennamo
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Medicine ,Science - Abstract
INTRODUCTION:Epiretinal traction is not responsible only for epiretinal but also intraretinal changes. This study aims to describe structural and vascular intraretinal changes after macular peeling in idiopathic (iERM) vs diabetic ERM (dERM). METHODS:We conducted a prospective interventional study on forty-two eyes, 23 with iERMs and 19 with dERMs, undergoing ERM-ILM peeling. We performed SD-OCT preoperatively, 1 and 6 months postoperatively to assess central macular thickness (CMT), intraretinal cysts (IC) and/or continuous ectopic inner foveal layers (CEIFL), superficial and deep capillary free zone (CFZ) area on OCT-A. Glial fibrillary acidic protein (GFAP), as a Müller cells marker, was detected immunohistochemically on ILM specimens, to assess Müller cells iatrogenic damage. RESULTS:The CEIFLs were significantly more common in iERMs (12 (52.2%) in iERMs vs 2 (10.5%) in dERMs, p = 0.004), whereas ICs in dERMs (6 (26.1%) in iERMs vs 17 (89.5%) in dERMs, p
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- 2018
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8. Changes in macular pigment optical density after membrane peeling.
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Mario R Romano, Gilda Cennamo, Piergiacomo Grassi, Federica Sparnelli, Davide Allegrini, and Giovanni Cennamo
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Medicine ,Science - Abstract
To highlight the differences in macular pigment optical density (MPOD) between eyes with vitreoretinal interface syndrome and healthy control eyes, to assess the changes in MPOD in eyes treated with macular peeling, to investigate the relationships between MPOD changes and measures of retinal sensitivity such as best corrected visual acuity (BCVA) and microperimetry.In this cross-sectional comparative study, 30 eyes affected by idiopathic epiretinal membrane (iERM, 15eyes) or full-thickness macular hole (FTMH, 15eyes) were compared with 60 eyes from 30 healthy age-matched patients. MPOD values (mean MPOD, maximum MPOD, MPOD area, and MPOD volume) were measured in a range of 4°-7° of eccentricity around the fovea, using the one-wavelength reflectometry method (Visucam 200, Carl-Zeiss Meditec). Patients affected by iERM and FTMH were treated with vitrectomy and epiretinal membrane-inner limiting membrane (ERM-ILM) peeling, with follow-up examinations performed preoperatively and 6 months postoperatively. The main outcome measures were the differences in MPOD between eyes with vitreoretinal interface syndrome and healthy eyes, changes in MPOD after ERM-ILM peeling, and relationships between MPOD and functional changes.Mean MPOD differed significantly between control eyes and those with iERM (P = .0001) or FTMH (P = .0006). The max MPOD and MPOD area increased, but not significantly. After peeling, the only significant change in MPOD was in MPOD volume (P = .01). In the ERM group, postoperative mean MPOD correlated significantly with best-corrected visual acuity (r = .739, P = .002).MPOD was reduced in patients with iERM or FTMH compared with healthy eyes. We found a significant correlation between the mean postoperative MPOD and postoperative BCVA, hypothesizing that the postoperative increase in mean MPOD could be due to a change in distribution for unfolding and expansion of the fovea after the peeling. MOPD may be considered as a prognostic factor associated with a good visual prognosis in patients with iERM.
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- 2018
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9. Correlation between various trace elements and ultramicroscopic structure of epiretinal macular membranes and glial cells.
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Mario R Romano, Gilda Cennamo, Daniela Montorio, Salvatore Del Prete, Mariantonia Ferrara, and Giovanni Cennamo
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Medicine ,Science - Abstract
INTRODUCTION:Elements such as zinc, iron, copper, sulphur and phosphorus have been identified in retinal layers and implicated in vital retinal functions. Regarding mineral composition of epiretinal membranes (ERMs), literature is lacking. This study aimed to analyze both mineral composition and anatomical ultrastructure of ERMs to clarify the pathophysiology of this disease. METHODS:Twenty ERMs (10 diabetic ERMs and 10 idiopathic ERMs) from 20 patients were harvested during pars plana vitrectomy. Scanning Electron Microscopy (SEM) was used to investigate the anatomical ultrastructure of the peeled ERMs. Mineral composition was analyzed using energy-dispersive spectrometry (EDS). The most frequent elements were evaluated in relation to appearance of ERMs analyzed at SEM and at OCT images. RESULTS:Sulphur was the most frequent element found (in 80% of the samples), followed by sodium (50%) and phosphorus (45%). The presence of these elements was not significantly different between diabetic and idiopathic ERMs (P >0.05). Using SEM we found a folded tissue in all ERMs, except in 4 ERMs, where we observed only a smooth tissue. There was a trend of sodium to be more frequent in ERMs with folded layers at SEM examination. CONCLUSIONS:Several elements were identified in ERMs, and sulphur, sodium and phosphorus were the most frequent ones. This finding may help to understand their role in the physiopatology of epiretinal proliferation and in glial activation.
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- 2018
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10. Correction: Intraretinal changes in idiopathic versus diabetic epiretinal membranes after macular peeling.
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Mario R Romano, Gennaro Ilardi, Mariantonia Ferrara, Gilda Cennamo, Davide Allegrini, Pia Clara Pafundi, Ciro Costagliola, Stefania Staibano, and Giovanni Cennamo
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Medicine ,Science - Abstract
[This corrects the article DOI: 10.1371/journal.pone.0197065.].
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- 2018
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11. Effect of Factor XIII-A G185T Polymorphism on Visual Prognosis after Photodynamic Therapy for Neovascular Macular Degeneration
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Francesco Parmeggiani, Ciro Costagliola, Francesco Semeraro, Mario R Romano, Michele Rinaldi, Carla Enrica Gallenga, Maria Luisa Serino, Carlo Incorvaia, Sergio D’Angelo, Katia De Nadai, Roberto Dell’Omo, Andrea Russo, Donato Gemmati, and Paolo Perri
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macular degenerations ,choroidal neovascularization ,pharmacogenetics ,photodynamic therapy with verteporfin ,fibrin-clot stability ,factor XIII-A G185T gene polymorphism ,anti-thrombophilia ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Macular degenerations represent leading causes of central blindness or low vision in developed countries. Most of these severe visual disabilities are due to age-related macular degeneration (AMD) and pathologic myopia (PM), both of which are frequently complicated by subfoveal choroidal neovascularization (CNV). Photodynamic therapy with verteporfin (PDT-V) is still employed for CNV treatment in selected cases or in combined regimen. In Caucasian patients, the common polymorphism G185T of factor XIII-A gene (FXIII-A-G185T; rs5985) has been described as predictor of poor angiographic CNV responsiveness to PDT-V. Nevertheless, the prognostic implications of this pharmacogenetic determinant on long-term visual outcome after a PDT-V regimen have not been evaluated. We retrospectively selected Caucasian patients presenting with treatment-naive CNV and receiving standardized PDT-V protocol for two years. The study population included patients affected by subfoveal CNV secondary to AMD or PM. We assessed the correlations between the polymorphic allele T of FXIII-A-G185T and: (1) total number of photodynamic treatments; and (2) change in visual acuity from baseline to the end of the follow-up period. Considering a total study population of 412 patients with neovascular AMD or PM, the carriers of 185 T-allele of FXIII-A (GT or TT genotype) received a higher number of photodynamic treatments than patients without it (GG wild-type genotype) (p < 0.01; mean number of PDT-V: 5.51 vs. 3.76, respectively). Moreover, patients with 185 T-allele of FXIII-A had a more marked worsening of visual acuity at 24 months than those with the GG-185 wild genotype (p < 0.01; mean difference in logMAR visual acuity: 0.22 vs. 0.08, respectively). The present findings show that the G185T polymorphism of the FXIII-A gene is associated with significant differences in the long-term therapeutic outcomes of patients treated with standardized PDT-V protocol. The comprehensive appraisal of both anti-thrombophilic effects due to FXIII-A G185T variant and photo-thrombotic action of PDT-V toward CNV provides several clues about the rationale of this intriguing pharmacogenetic correlation. Further investigations are warranted to outline the appropriate paradigm for guiding PDT-V utilization in the course of the combined therapeutic protocol for neovascular macular degeneration.
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- 2015
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12. Development of ocular hypertension secondary to tamponade with light versus heavy silicone oil: A systematic review
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Vito Romano, Mario Cruciani, Francesco Semeraro, Ciro Costagliola, and Mario R Romano
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Intraocular ,lymphoma ,retina ,vitreous ,Conjunctiva ,cornea ,melanoma ,ocular surface ,ocular surface squamous neoplasia ,tumor ,Brachytherapy ,chemotherapy ,cryopexy ,intra ocular tumors ,photocoagulation ,Animal uveitis model ,cytomegalovirus retinitis animal model ,endotoxin-induced uveitis ,experimental autoimmune uveitis ,spontaneous ,tubercular uveitis animal model ,India ,genetics ,retinoblastoma ,review ,Glaucoma ,heavy silicone oil ,light silicone oil ,ocular hypertension ,retinal detachment ,standard silicone oil ,Ophthalmology ,RE1-994 - Abstract
Aim: The intraocular silicone oil (SO) tamponades used in the treatment of retinal detachment (RD) have been associated with a difference ocular hypertension (OH) rate. To clarify, if this complication was associated to use of standard SO (SSO) versus heavy SO (HSO), we performed a systematic review and meta-analysis of comparative study between two kind of SO (standard or light vs. heavy) for the treatment of RD and macular hole, without restriction to study design. Materials and Methods: The methodological quality of two randomized clinical trials (RCTs) were evaluated using the criteria given in the Cochrane Handbook for Systematic Reviews of Intervention, while three non-RCTs were assessed with the Newcastle-Ottawa Scale and Strengthening the Reporting of Observational Studies in Epidemiology checklists. We calculated Mantel-Haenszel risk ratio (RR) with 95% confidence intervals (95% CIs). The primary outcome was the rate of patients with OH treated with SSO compared to HSO. Results: There were a higher number of rates of OH in HSO compared to SSO. This difference was statistically significant with the fixed effect model (Mantel-Haenszel RR; 1.55; 95% CI, 1.06-2.28; P = 0.02) while there was not significative difference with the random effect model (Mantel-Haenszel RR; 1.51; 95% CI, 0.98-2.33; P = 0.06). Conclusion: We noted a trend that points out a higher OH rate in HSO group compared to SSO, but this finding, due to the small size and variable design of studies, needs to be confirmed in well-designed and large size RCTs.
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- 2015
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13. Correction: miRNAs in the vitreous humor of patients affected by idiopathic epiretinal membrane and macular hole.
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Andrea Russo, Marco Ragusa, Cristina Barbagallo, Antonio Longo, Teresio Avitabile, Maurizio G Uva, Vincenza Bonfiglio, Mario D Toro, Rosario Caltabiano, Cesare Mariotti, Francesco Boscia, Mario R Romano, Cinzia Di Pietro, Davide Barbagallo, Michele Purrello, and Michele Reibaldi
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Medicine ,Science - Abstract
[This corrects the article DOI: 10.1371/journal.pone.0174297.].
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- 2017
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14. Primary 23-gauge sutureless vitrectomy for rhegmatogenous retinal detachment
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Mario R Romano, Ronald Das, Carl Groenwald, Theo Stappler, Joaquin Marticorena, Xavier Valldeperas, David Wong, and Heinrich Heimann
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Band-shaped keratopathy ,corneal dystrophy ,phototherapeutic keratectomy ,phototherapeutic keratectomy with amniotic membrane grafts ,scar ,and Salzmann nodular degeneration ,Kaplan Meier survival analysis ,multivariate Cox Proportional Hazard Regression analysis ,optical penetrating keratoplasties ,Myopia ,phakic refractive intraocular lens ,refractive surgery ,23-Gauge vitrectomy ,rhegmatogenous retinal detachment ,sutureless vitrectomy ,Ophthalmology ,RE1-994 - Abstract
Aims : To report a prospective non-comparative consecutive interventional study on the safety and efficacy of 23-Gauge transconjunctival sutureless pars plana vitrectomy for primary rhegmatogenous retinal detachment (RRD). Materials and Methods: Fifty eyes of 50 consecutive patients were recruited between June 2007 and January 2008. All surgeries were performed using the one-step 23-Gauge system with angled incisions. The surgical protocol consisted of a minimum of eight clinical visits: baseline, 1 day, 1 week, 1-, 3- and 6- months after the initial surgery. The endpoints were anatomical, functional results and complications arising from the surgery. Results : Anatomical success was achieved in 82% of cases (41 out of 50) with single surgery and rose to 98% (49 out of 50) with additional surgery. Mean visual acuity improved from logMAR 0.48(SD 0.36) to 0.26(SD 0.31), P < 0.001. Two cases with ocular hypotony, defined as an intraocular pressure ≤ 6mmHg, that were associated with a choroidal detachment were seen. Conclusions : Acceptable anatomical and functional success rates can be achieved with primary 23-Gauge transconjunctival sutureless vitrectomy for RRD. We found that the approach technique is different from conventional vitrectomy and the complications arising from post surgical hypotony and leakage from sclerotomies are potentially higher compared to 20-Gauge vitrectomy.
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- 2012
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15. Analysis of photoastigmatic keratectomy with the cross-cylinder ablation
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Nicola Rosa, Maddalena De Bernardo, Mario R Romano, Gianluca Scarfato, Francesco Verdoliva, Rodolfo Mastropasqua, and Michele Lanza
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Apoptosis ,glaucoma ,intraocular pressure ,retinal ganglion cells ,retinal ischemia ,tumor necrosis factor-alpha ,Branch retinal vein occlusion ,laser ,Lucentis ,macular edema ,Microbial etiology ,mucopurulent keratitis ,suppurative keratitis ,Intraoperative application of mitomycin C ,mitomycin C ,postoperative complications ,preoperative subconjunctival injection ,recurrence rate ,recurrent pterygium ,Cataract ,inflammation ,mydriasis ,prevention and control ,surgery ,Cross-cylinder technique ,photoastigmatic refractive keratectomy ,refractive surgery ,Ophthalmology ,RE1-994 - Abstract
Aim: The aim was to evaluate the safety and efficacy of the "cross-cylinder" technique in the correction of astigmatism. Setting and Design: A prospective interventional study from a university eye department was conducted. Material and Methods: The photoastigmatic refractive keratectomy (PARK) using the "cross-cylinder" technique was performed in 102 eyes of 84 patients with at least 0.75 D of astigmatism. The study population was divided into two groups: in the first group the preoperative astigmatic power ranged from −0.75 D to −3.00 D (group 1), in the second group it ranged from −3.25 D to −6.00 D (group 2). Group 1 included 82 eyes of 67 patients (29 males and 38 females) with a mean cylinder power of −1.90 ± 0.63 D, group 2 included 20 eyes of 17 patients (13 males and 4 females) with a mean cylinder power of -4.28 ± 0.76 D. All eyes were targeted for emmetropia. The results were evaluated using Calossi′s vector analysis method. Six-month postoperative outcomes are presented. Results: Six months after PARK the mean sphere for the entire cohort was +0.28 ± 0.75 D (range +2.5 to −2 D), the mean cylindrical power was +0.33 ± 0.51 D (range +2.5 to −1.25 D) and the mean spherical equivalent refraction was +0.73 ± 0.81 D (range +1.75 to −2 D). Conclusions: The cross-cylinder technique may be safely used with predictable results for the correction of astigmatism.
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- 2012
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16. Quality of vision in patients implanted with aspherical and spherical intraocular lens: Intraindividual comparison
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Francesco Semeraro, Mario R Romano, Sarah Duse, and Ciro Costagliola
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Mean deviation ,non-proliferative diabetic retinopathy ,short fluctuations ,short wave automated perimetry ,standard automated perimetry ,Antimicrobial effect ,conventional silicone oil ,endophthalmitis agents ,heavy silicone oil ,Keratoconus ,modified deep anterior lamellar keratoplasty ,steep corneal curvature ,Bevacizumab ,branch retinal vein occlusion ,intravitreal ,macular edema ,triamcinolone ,Blindness ,disability evaluation ,quality of life ,visual acuity ,Mitomycin C ,pterygium recurrence ,pterygium surgery ,subconjunctival bevacizumab injection ,Imaging in glaucoma ,optical coherence tomography ,pediatric ,retinal nerve fiber layer ,Autogenous tissue grafting ,lacrimal drainage system ,lacrimal fossa ,bypass surgery ,Cornea ,excimer laser ,growth factors ,myopia ,photorefractive keratectomy ,Triamcinolone acetonide ,human trabecular meshwork cells ,in vitro ,Hyperopic implantable collamer lens ,myopic implantable collamer lens ,optical quality ,wavefront aberrations ,Dacryocystorhinostomy ,nasolacrimal duct obstruction ,silicone tube ,Age ,anterior chamber depth ,body height ,primary angle closure glaucoma ,sex ,Children ,eye injury vitrectomy study ,eye injury ,trauma ,vitrectomy ,Corneal biomechanics ,corneal hysteresis ,corneal resistance factor ,intraocular pressure ,keratoplasty ,ocular response analyser ,Aspherical intraocular lens ,quality of vision ,spherical aberrations ,Ophthalmology ,RE1-994 - Abstract
Aims: To compare the quality of vision in pseudophakic patients implanted with aspherical and spherical intraocular lenses (IOLs). Materials and Methods: Randomized prospective longitudinal intrapatient comparison between aspherical and spherical IOLs performed on 22 patients who underwent bilateral cataract surgery. Best corrected visual acuity, subjective contrast sensitivity, Strehl ratio and spherical aberrations (SA), and higher order wavefront aberrations for a 3.5 mm and a 6.0 mm pupil were measured after 3 months of cataract surgery. Results: SA (Z4,0) decreased significantly in eyes with aspherical IOL implant (P = 0.004). Modulation transfer function (MTF) and point spread function (PSF) resulted no significant difference between the two groups (P = 0.87; P = 0.32). Conclusion: Although the SA is significantly lower in eyes implanted with aspherical IOL, the quality of vision determined with MTF and PSF does not significantly differ for subjective and objective parameters that were analyzed.
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- 2014
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17. Combined photodynamic therapy and intravitreal bevacizumab for idiopathic polypoidal choroidal vasculopathy: one-year follow-up
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Mario R Romano, Ugo Cipollone, Francesco Semeraro, and et al
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Ophthalmology ,RE1-994 - Abstract
Mario R Romano1, Ugo Cipollone2, Francesco Semeraro3, Michele Rinaldi4, Ciro Costagliola11Dipartimento di Scienze per la Salute, Università degli Studi del Molise, Campobasso; 2Dipartimento di Oftalmologia, Ospedale G Vietri, Larino, Campobasso; 3Clinica Oculistica, Università degli Studi di Brescia, Brescia; 4Clinica Oculistica, II Università degli Studi di Napoli, Napoli, ItalyObjective: To report the efficacy and safety of combined photodynamic therapy (PDT) and intravitreal bevacizumab (IVB) injection in the treatment of idiopathic polypoidal choroidal vasculopathy (IPCV).Material and methods: A prospective case series of 10 eyes of 10 consecutive patients affected by IPCV with subfoveal involvement. PDT plus IVB (1.25 mg/0.05 mL) injection two weeks later was performed in all patients. Two adjunctive injections of bevacizumab were scheduled at four and eight weeks after the initial treatment. Best-corrected visual acuity (BCVA), fluorescein and indocyanine green angiographies, and optical coherence tomography were obtained at baseline, and at one, three, six, nine, and 12 months.Results: The combined treatment led to an improvement of both neurosensory detachment and pigmented epithelial detachment in all eyes, with a decrease of exudation and regression of macular thickness, which remained stable to the end of follow-up. However, BCVA remained stable over the 12 months of follow-up.Conclusion: These findings demonstrate that PDT/IVB combined therapy is able to achieve morphologic stabilization of the IPCV lesion, through a rapid decrease of macular thickness and regression of the size of polypoidal vascular lesion.Keywords: combined treatment, idiopathic polypoidal choroidal vasculopathy, age-related macular degeneration, intravitreal bevacizumab, photodynamic therapy
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- 2010
18. Retinal and Corneal Changes Associated with Intraocular Silicone Oil Tamponade
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Mariantonia Ferrara, Giulia Coco, Tania Sorrentino, Kirti M. Jasani, George Moussa, Francesco Morescalchi, Felipe Dhawahir-Scala, Francesco Semeraro, David H. W. Steel, Vito Romano, and Mario R. Romano
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confocal microscopy ,cornea ,corneal endothelial cell count ,optical coherence tomography ,pars plana vitrectomy ,retina ,Medicine - Abstract
Silicone oils (SO) are used as long-term intraocular tamponades and have an irreplaceable role in vitreoretinal surgery. They can, however, be associated with multiple and potentially severe complications, involving different ocular tissues, in particular retina and cornea. Recent advances in ophthalmic imaging have allowed the precise characterization of retinal and corneal microstructural changes, at a subclinical level. This detailed analysis of SO-related retinal and corneal changes has improved our understanding of their pathogenesis and offer the potential for optimized monitoring and management of patients with SO-filled eyes. This review aims to provide clinicians and ophthalmic scientists with an updated and comprehensive overview of the corneal and retinal changes associated with SO tamponade.
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- 2022
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19. OCT Analysis of Retinal Pigment Epithelium in Myopic Choroidal Neovascularization: Correlation Analysis with Different Treatments
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Davide Allegrini, Diego Vezzola, Alfredo Borgia, Raffaele Raimondi, Tania Sorrentino, Domenico Tripepi, Elisa Stradiotto, Marco Alì, Giovanni Montesano, and Mario R. Romano
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medical retina ,myopia ,CNV ,myopic choroidal neovascularization ,OCT ,Medicine - Abstract
Objective: The objective of this study was to analyze the status of the retinal pigment epithelium (RPE) by means of the spectral domain optical coherence tomography (SD-OCT) overlying the myopic neovascular lesions in the involutive phase, looking for any correlations between the status of the RPE and the size of the lesions and the type and duration of the treatment. Methods: SD-OCT examinations of 83 consecutive patients with myopic choroidal neovascularization (CNV) were reviewed and divided into two groups: group A, patients with CNV characterized by uniformity of the overlying RPE, and group B, patients with CNV characterized by non-uniformity of the overlying RPE. Results: The median lesion area, major diameter, and minimum diameter were, respectively, 0.42 mm2 (0.30–1.01 mm2), 0.76 mm2 (0.54–1.28 mm2), and 0.47 mm2 (0.63–0.77 mm2) in group A, and 1.60 mm2 (0.72–2.67 mm2), 1.76 mm2 (1.13–2.23 mm2), and 0.98 mm2 (0.65–1.33 mm2) in group B. These values were lower in group A than in group B (p < 0.001). The number of treatments with a period free of disease recurrence for at least 6 months was greater (p < 0.010) in group B (6.54 ± 2.82) than in group A (3.67 ± 2.08), and treatments include intravitreal anti-vascular endothelial growth factor injection, photodynamic therapy, or both. Conclusions: Our results showed that the size of myopic neovascular lesion influences the development of a uniform RPE above the lesion and therefore the disease prognosis. The presence of uniform RPE was found to be extremely important in the follow-up of patients with myopic CNV, as it influences the duration of the disease and the number of treatments required.
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- 2022
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20. Full-Thickness Macular Hole: Are Supra-RPE Granular Deposits Remnants of Photoreceptors Outer Segments? Clinical Implications
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Andrea Govetto, Daniela Bacherini, Mario R. Romano, Martina Matteucci, Sara Lucchini, Lorenzo Cifarelli, Francesco Dragotto, Matteo Cereda, Salvatore Parrulli, Giovanni Staurenghi, Fabrizio Giansanti, Gianni Virgili, Ferdinando Bottoni, and Paolo Radice
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Ophthalmology - Abstract
To describe the presence of specific morphological characteristics of idiopathic, full-thickness macular hole (MH) potentially influencing postoperative best corrected visual acuity (BCVA) and surgical outcomes.Retrospective, multicenter and interventional case series.Clinical charts and multimodal imaging pictures of 149 eyes of 143 consecutive patients diagnosed with MH, treated surgically and with a minimum follow-up of 12 months, were reviewed.Supra-retinal pigment epithelium (RPE) granular deposits were diagnosed in 121 of 149 eyes (81.2%). A smooth morphology was identified in 58 of 149 eyes (38.9%), whereas a bumpy border was present 91 of 149 eyes (61.1%). Photoreceptor disruption was mainly located close to the MH aperture. In 8% of the included cases, preoperative anatomical progression from smooth to bumpy morphology was noted. The presence of supra-RPE granular deposits was a significant predictor of lower postoperative BCVA only in univariate analysis (P.001). The presence of a bumpy border was significantly correlated with lower postoperative BCVA in both univariate and multivariate analysis (P.001). BCVA gain was significantly lower in MH with bumpy borders (P.001). A bumpy border was also significantly associated with poor postoperative anatomical restoration (P.001).Supra RPE-granular deposits and a bumpy morphology may be indicators of photoreceptor disruption in MH. A bumpy morphology may suggest deeper and potentially irreversible photoreceptor damage, and may negatively influence both functional and anatomical recovery.
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- 2023
21. A generalised porous medium approach to study thermo-fluid dynamics in human eyes.
- Author
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Alessandro Mauro, Nicola Massarotti, Mohamed Salahudeen, Mario R. Romano, Vito Romano, and Perumal Nithiarasu
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- 2018
- Full Text
- View/download PDF
22. VEGF and PEDF in Patients With Myopic Choroidal Neovascularization
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Ciro Costagliola, Francesco Semeraro, Roberto dell'Omo, Mario R Romano, Fabiana Aceto, Rodolfo Mastropasqua, Antonio Porcellini, and Andrea Russo, MD, PhD Researcher
- Published
- 2014
23. Visusminderung und Silikonöltamponade
- Author
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Armin Wolf, Mario R. Romano, and Christos Haritoglou
- Published
- 2022
24. Modeling pulmonary cystic fibrosis in a human lung airway-on-a-chip
- Author
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Ratnakar Potla, Chaitra Belgur, Mark Cartwright, Amanda Jiang, Mercy Soong, Donald E. Ingber, Renee N. Travis, Haiqing Bai, Roberto Plebani, Alexandre L. M. Dinis, Sarah E. Gilpin, Rachelle Prantil-Baun, Pawan Jolly, Zohreh Izadifar, and Mario R. Romano
- Subjects
Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,Cystic Fibrosis ,Mucociliary clearance ,Cystic Fibrosis Transmembrane Conductance Regulator ,Inflammation ,Cystic fibrosis ,Proinflammatory cytokine ,Lab-On-A-Chip Devices ,medicine ,Humans ,Respiratory system ,Lung ,Cells, Cultured ,biology ,business.industry ,Endothelial Cells ,respiratory system ,medicine.disease ,Mucus ,Cystic fibrosis transmembrane conductance regulator ,respiratory tract diseases ,Pseudomonas aeruginosa ,Pediatrics, Perinatology and Child Health ,biology.protein ,medicine.symptom ,Airway ,business - Abstract
Background Cystic fibrosis (CF) is a genetic disease caused by mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR), which results in impaired airway mucociliary clearance, inflammation, infection, and respiratory insufficiency. The development of new therapeutics for CF are limited by the lack of reliable preclinical models that recapitulate the structural, immunological, and bioelectrical features of human CF lungs. Methods We leveraged organ-on-a-chip technology to develop a microfluidic device lined by primary human CF bronchial epithelial cells grown under an air-liquid interface and interfaced with pulmonary microvascular endothelial cells (CF Airway Chip) exposed to fluid flow. The responses of CF and healthy Airway Chips were analyzed in the presence or absence of polymorphonuclear leukocytes (PMNs) and the bacterial pathogen, Pseudomonas aeruginosa. Results The CF Airway Chip faithfully recapitulated many features of the human CF airways, including enhanced mucus accumulation, increased cilia density, and a higher ciliary beating frequency compared to chips lined by healthy bronchial epithelial cells. The CF chips also secreted higher levels of IL-8, which was accompanied by enhanced PMN adhesion to the endothelium and transmigration into the airway compartment. In addition, CF Airway Chips provided a more favorable environment for Pseudomonas aeruginosa growth, which resulted in enhanced secretion of inflammatory cytokines and recruitment of PMNs to the airway. Conclusions The human CF Airway Chip may provide a valuable preclinical tool for pathophysiology studies as well as for drug testing and personalized medicine.
- Published
- 2022
25. Optical-Quality Assessment of a Miniaturized Intraocular Telescope
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Irene Nepita, Raffaele Raimondi, Simonluca Piazza, Alberto Diaspro, Faustino Vidal-Aroca, Salvatore Surdo, and Mario R. Romano
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end-stage age-related macular degeneration ,visual impairment ,visual prosthesis ,implantable ophthalmic device ,intraocular lens ,optical performance ,geometrical aberrations ,SING IMT™ ,General Medicine - Abstract
PurposeEvaluating the optical transmission and geometrical aberrations of an intraocular device, namely, the Small-Incision New Generation Implantable Miniature Telescope (SING IMT™, Samsara Vision), designed to correct age-related macular degeneration.MethodsOptical transmission in the spectral range 350-750 nm of the implantable optics was recorded with a fiber-optic spectrometer. Geometrical aberrations were studied by measuring the wavefront of a laser beam after passing through the implantable optics and performing an expansion of the measured wavefront into a Zernike polynomial basis. The study was conducted underin-vitroexperimental conditions. A second monofocal intraocular lens (SY60WF, Alcon) was tested and used as reference for assessing the optical quality of the SING IMT™ device.ResultsSpectroscopy measurements revealed that the SING IMT™ and monofocal IOL element feature UV-rejection and blue-rejection capabilities, respectively. Wavefront concavity indicated that the SING IMT™ behaves as a diverging lens with a focal length of approximately -100 mm; Zernike analysis showed that SING IMT™ has negligible coma, trefoil, astigmatism, and spherical aberrations of any order and along any direction.ConclusionsThe SING IMT™ exhibited even optical transmission in the whole visible spectrum and curvature capable of magnifying the retinal images without introducing geometrical aberrations, which proves the feasibility of this device as high-quality optical element for imaging. The rigidity of the compound lens of the SING IMT™ prevents mechanically-induced distortions, an issue encountered with polymeric lenses.Translational RelevanceSpectrometry andin vitrowavefront analysis provide evidence supporting the new generation miniaturized telescopic intraocular lens as a favorable option to intraocular implant in age-related macular degeneration.
- Published
- 2023
- Full Text
- View/download PDF
26. Macular hole Delphi consensus statement (MHOST)
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Filippo Confalonieri, Hanna Haave, Susanne Binder, Agnieszka Monika Bober, Ragnheidur Bragadottir, Thomas Bærland, Rowan Faber, Vegard Forsaa, Julio J. Gonzalez‐Lopez, Andrea Govetto, Marta Haugstad, Domagoj Ivastinovic, Neža Čokl Jenko, Simona Delia Nicoară, Kuldar Kaljurand, Igor Kozak, Anders Kvanta, Lyubomyr Lytvynchuk, Zofia Anna Nawrocka, Sanja Petrovic Pajic, Mojca Globočnik Petrovič, Liga Radecka, Matus Rehak, Mario R. Romano, Andrii Ruban, Martynas Speckauskas, Ingar Stene‐Johansen, Zbynek Stranak, Angela Thaler, Anna Sophie Aagaard Thein, Ioannis Theocharis, Zoran Tomic, Xiaohe Yan, Muhamet Zekolli, Burim Zhuri, Ljubo Znaor, Beata Eva Petrovski, Miriam Kolko, Xhevat Lumi, and Goran Petrovski
- Subjects
Ophthalmology ,General Medicine - Published
- 2023
27. Recommendation for presbyopia-correcting intraocular lenses: A Delphi consensus statement by the ESASO study group
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Vito Romano, David Madrid-Costa, Jose F. Alfonso, Jorge Alio, Bruce Allan, Romesh Angunawela, Gerd Auffarth, Francesco Carones, Ramin Khoramnia, Johnny Moore, Mayank A. Nanavaty, Giacomo Savini, Luca Pagano, Mario R Romano, Gianni Virgili, and Luis Fernández-Vega-Cueto
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Ophthalmology - Published
- 2023
28. Scleral buckle, vitrectomy, or combined surgery for inferior break retinal detachment: Systematic review and meta-analysis
- Author
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Jonathan Bonnar, Chin Han Tan, Philip McCullough, David M. Wright, Tom Williamson, Noemi Lois, Abdussalam M. Abdullatif, Radwan Ajlan, Antonio Capone, Marcus Colyer, Roberto Dell’Omo, Dean Eliott, Geoff Emerson, Omesh Gupta, Jason Hsu, Daniel P. Joseph, Vicente Matinez-Castillo, Ahmed A. Mohalhal, Marco Mura, Carl Regillo, Flavio A. Rezende, Mario R. Romano, Ed Ryan, Matthew Starr, Manfred Von Fricken, Louisa Wickham, and Yoshihiro Yonekawa
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Ophthalmology - Published
- 2023
29. InTraocular EMulsion of Silicone oil (ITEMS) grading system: an evidence-based expert-led consensus
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Mario R Romano, Mariantonia Ferrara, Rosa M Coco-Martin, Annekatrin Rickmann, Martin S Spitzer, David HW Steel, and J Carlos Pastor
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Ophthalmology ,General Medicine - Published
- 2023
30. Trans-Scleral Plugs Fixated FIL SSF IOL: A Review of the Literature and Comparison with Other Secondary IOL Implants
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Raffaele Raimondi, Tania Sorrentino, Raphael Kilian, Yash Verma, Francesco Paolo De Rosa, Giuseppe Cancian, Panos Tsoutsanis, Giovanni Fossati, Davide Allegrini, and Mario R. Romano
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suture less fixation ,secondary implant ,Carlevale lens ,scleral fixated intraocular lens ,General Medicine - Abstract
Purpose. To revise the current literature on FIL SSF (Carlevale) intraocular lens, previously known as Carlevale lens, and to compare their outcomes with those from other secondary IOL implants. Methods. We performed a peer review of the literature regarding FIL SSF IOLs until April 2021 and analyzed the results only of articles with a minimum of 25 cases and a follow-up of at least 6 months. The searches yielded 36 citations, 11 of which were abstracts of meeting presentations that were not included in the analysis because of their limited data. The authors reviewed 25 abstracts and selected six articles of possible clinical relevance to review in full text. Of these, four were considered to be sufficiently clinically relevant. Particularly, we extrapolated data regarding the pre- and postoperative best corrected visual acuities (BCVA) and the complications related to the procedure. The complication rates were then compared with those from a recently published Ophthalmic Technology Assessment by the American Academy of Ophthalmology (AAO) on secondary IOL implants. Results. Four studies with a total of 333 cases were included for results analysis. The BCVA improved in all cases after surgery, as expected. Cystoid macular edema (CME) and increased intraocular pressure were the most common complications, with an incidence of up to 7.4% and 16.5%, respectively. Other IOL types from the AAO report included anterior chamber IOLs, iris fixation IOLs, sutured iris fixation IOLs, sutured scleral fixation IOLs, and sutureless scleral fixation IOLs. There was no statistically significant difference in the rates of postoperative CME (p = 0.20), and vitreous hemorrhage (p = 0.89) between other secondary implants and the FIL SSF IOL, whereas the rate of retinal detachment was significantly less with FIL SSF IOLs (p = 0.04). Conclusion. The results of our study suggest the implantation of FIL SSF IOLs is an effective and safe surgical strategy in cases where there is a lack of capsular support. In fact, their outcomes seem to be comparable to those obtained with the other available secondary IOL implants. According to published literature, the FIL SSF (Carlevale) IOL provides favorable functional results with a low rate of postoperative complications.
- Published
- 2023
31. Safety Profile of Lutein-Versus Triamcinolone Acetonide–Based Vitreous Staining
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Francesca Lazzara, Federica Conti, Mariantonia Ferrara, Myrta Lippera, Michele Coppola, Settimio Rossi, Filippo Drago, Claudio Bucolo, and Mario R. Romano
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Ophthalmology ,Staining and Labeling ,Lutein ,Preservatives, Pharmaceutical ,Biomedical Engineering ,Humans ,Triamcinolone Acetonide - Abstract
To assess the safety profile of a new lutein-based vitreous dye (LB-VD) formulation compared with various triamcinolone acetonide (TA) formulations with and without subsequent exposure to perfluorodecalin (PFD) in vitro.Human adult retinal pigment epithelial cells (ARPE-19) were treated with the following formulations: undiluted preserved TA (TA-BA), diluted preserved TA (D-TA-BA), preservative-free TA (TA-PF), and LB-VD. First, cell tolerability was evaluated with MTT, LDH, and ATPlite assays after 1, 5, and 30 minutes of exposure to each tested formulation. Then, cells were sequentially exposed to formulations and PFD. After 24 hours of exposure to PFD, cell tolerability was evaluated through MTT and ATPlite assays.Among the formulations tested, LB-VD showed the highest levels of cell viability, cell metabolism, and cell proliferation and induced the lowest release of LDH, whereas the TA-based formulations demonstrated a cytotoxic effect on ARPE-19 cells in vitro. After subsequent 24-hour exposure to PFD, a greater reduction of cell viability was noted for all the formulations; however, this reduction was not significant only for the combination LB-VD-PFD, which was the best tolerated condition.LB-VD showed a better safety profile compared with all TA-based formulations, even when used in combination with PFD.In surgical practice, LB-VD may be preferred to TA-based formulations for vitreous staining in the light of its more favorable safety profile.
- Published
- 2023
32. TWENTY-THREE–GAUGE HYPERSONIC VITRECTOMY
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Mario R. Romano, Matteo Fallico, Teresio Avitabile, Mariantonia Ferrara, Alvise La Gloria Valerio, Rodolfo Repetto, and Luigi Caretti
- Subjects
Male ,medicine.medical_specialty ,Visual acuity ,genetic structures ,medicine.medical_treatment ,Visual Acuity ,Vitrectomy ,Endotamponade ,Vitreoretinal Surgery ,Retinal Diseases ,Ultrasonic Surgical Procedures ,medicine ,Humans ,Vitreous liquefaction ,Prospective Studies ,Intraoperative Complications ,Vitreous strands ,Aged ,Phacoemulsification ,business.industry ,Vitreous incarceration ,General Medicine ,Vitreoretinal surgery ,Middle Aged ,eye diseases ,Surgery ,Ophthalmology ,Treatment Outcome ,Female ,sense organs ,medicine.symptom ,business - Abstract
PURPOSE To evaluate the safety, effectiveness, and the best parameters setup of hypersonic vitrectomy. METHODS A prospective, multicentric, interventional study on 50 eyes that had undergone hypersonic vitrectomy because of various vitreoretinal diseases. We primarily assessed the effectiveness of vitreous removal, intraoperative complications, and surgical setup. Secondarily, we evaluated single-surgery anatomical success and postoperative best-corrected visual acuity. RESULTS Intraoperative complications occurred in 5 eyes (10%), whereas technical problems were detected in 23 eyes (46%), resulting in conversion to guillotine vitrectomy in 15 cases. The most common finding related to the technical problems was an inadequate vitreous liquefaction with the formation of vitreous strands and consequent inadequate vitreous outflow, sometimes complicated by vitreous incarceration in the vitrectomy probe. The best settings were considered a stroke of 60 µm and vacuum of 40 mmHg for both core and peripheral vitrectomy. At 3-month follow-up, primary anatomical success was achieved in 49 eyes (98%) and the mean best-corrected visual acuity overall improved. CONCLUSION The availability of hypersonic vitrectomy in the current surgical practice opens a new era in vitreoretinal surgery. Despite the potential advantages in fluidics, the performance of hypersonic vitrectomy system needs to be further optimized, mainly for the occurrence of inadequate vitreous liquefaction and vitreous strands formation.
- Published
- 2021
33. 25 Simulation of eye surgery in porcine eye globes and evaluation of retinal cytotoxicity
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Jana D’amato Tothova, Claudio Gatto, Laura Giurgola, Mario R Romano, and Mariantonia Ferrara
- Published
- 2022
34. [Visual acuity reduction and silicone oil tamponade]
- Author
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Armin, Wolf, Mario R, Romano, and Christos, Haritoglou
- Subjects
Vitrectomy ,Retinal Detachment ,Visual Acuity ,Humans ,Silicone Oils ,Tomography, Optical Coherence - Abstract
Silicone oil is an established intraocular surgical aid, which enables the treatment of the most complex starting situations but no other alternative has been found; however, the available data indicate that an unclear loss of visual acuity during or after an intraocular silicone oil tamponade possibly occurs more frequently than assumed from the clinical routine. Various pathological mechanisms are under discussion as causes, but the exact causes are actually unclear. In addition to atrophic alterations in the optical coherence tomography (OCT) examination, there are a clear reduction in visual acuity and mostly a central scotoma with otherwise inconspicuous findings. Unclear loss of visual acuity can also occur after removal of the silicone oil. Whether this is caused by the same pathological mechanism is unclear. Furthermore, there are no reproducible risk factors that appear a priori to possibly cause an unclear loss of vision under silicone oil; however, oil removal as soon as possible and a good adjustment of the intraocular pressure are recommended by the authors. Overall, a silicone oil tamponade should be carefully weighed up even when using modern highly purified silicone oils and it should therefore continue to be reserved particularly for unfavorable initial situations or complicated courses with the necessity for a silicone oil tamponade. Against this background, a study for systematic recording and processing of cases of unclear loss of visual acuity after silicone oil tamponade seems to be meaningful.Silikonöl ist ein etabliertes und bis heute durch keine Alternative zu ersetzendes intraokular chirurgisches Hilfsmittel, das die Versorgung von komplexesten Ausgangssituationen ermöglicht. Verfügbare Daten weisen jedoch darauf hin, dass eine unklare Visusminderung während oder nach einer intraokularen Silikonöltamponade möglicherweise häufiger auftritt, als dies der klinische Alltag vermuten lässt. Unterschiedliche Pathomechanismen werden hierfür ursächlich diskutiert, tatsächlich sind die genauen Ursachen aber unklar. Neben atrophischen Veränderungen in der OCT(optische Kohärenztomographie)-Untersuchung finden sich ein deutlich reduzierter Visus sowie meist ein Zentralskotom bei sonst unauffälligen Befunden. Unklare Visusminderungen können auch nach einer Silikonölentfernung auftreten. Ob hier die gleichen Pathomechanismen ursächlich sind, ist unklar. Ferner gibt es keine reproduzierbaren Risikofaktoren, die eine unklare Visusminderung unter Silikonöl a priori wahrscheinlich erscheinen lassen, jedoch werden möglichst frühzeitige Ölentfernung und gute Einstellung des intraokularen Druckes von den Autoren empfohlen. Insgesamt sollte eine Silikonöltamponade auch unter Verwendung von modernen hoch-aufgereinigten Silikonölen sorgfältig abgewogen werden und damit weiterhin v. a. ungünstigen Ausgangssituationen oder komplizierten Verläufen mit Notwendigkeit einer Silikonöltamponade vorbehalten bleiben. Vor diesem Hintergrund scheint eine Studie zur systematischen Erfassung und Aufarbeitung der Fälle von unklarer Visusminderung nach Silikonöltamponade sinnvoll.
- Published
- 2022
35. Myopic macular schisis: Insights into distinct morphological subtypes and novel biomechanical hypothesis
- Author
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Mayss Al-Sheikh, Andrea Govetto, Nopasak Phasukkijwatana, Martina Matteucci, Rodolfo Repetto, Mario R Romano, Gianni Virgili, Sandrine Zweifel, Daniel Barthelmes, K Bailey Freund, SriniVas R Sadda, and David Sarraf
- Subjects
Ophthalmology ,General Medicine - Abstract
Purpose To analyze the features of myopic macular schisis (MMS) in different retinal layers and to explore the role of Müller cells in the pathophysiology of such condition. Methods Spectral-domain optical coherence tomography (SD-OCT) images of myopic eyes with staphyloma and macular schisis were reviewed. The morphological features of MMS were analyzed and correlated with their geographical location in the parafoveal and perifoveal region. A biomechanical model was adopted to explain MMS morphological differences. The effect of the different schisis subtypes with best corrected visual acuity (BCVA) was also explored. Results A total of 36 eyes from 26 patients were included in this study. MMS was classified into inner, middle and outer retinal subtypes. The prevalence of middle retinal schisis was significantly lower in the parafovea, within a central 3 mm-diameter circle (p Conclusion Three major forms of MMS are distinguished: inner, middle and outer retinal schisis. This classification may have clinical importance as only the outer grade of schisis was associated with vision loss.
- Published
- 2023
36. Phacoemulsification Tip Elongation Under Standardized Resistance: An Objective Measure of Human Crystalline Lens Hardness
- Author
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Tommaso Rossi, Mario R. Romano, Antonio Carotenuto, Carlo Malvasi, Giov Battista Angelini, Alessandro Rossi, Serena Telani, Guido Ripandelli, and Giorgio Querzoli
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Ophthalmology ,Biomedical Engineering - Published
- 2023
37. Pneumatic retinopexy versus scleral buckling for the management of primary rhegmatogenous retinal detachment
- Author
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Marzio Chizzolini, Ferdinando Martini, Riccardo Melis, Alessio Montericcio, Raffaele Raimondi, Davide Allegrini, and Mario R Romano
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Ophthalmology ,General Medicine - Abstract
Background and objective To compare pneumatic retinopexy (PnR) and scleral buckling (SB) for repair of primary rhegmatogenous retinal detachment. Materials and Methods Single-centre retrospective analysis of patients undergoing PnR and SB. Inclusion criteria comprehend phakic patients with a single retinal break or a group of breaks in detached retina in the same quadrant above the 8- and 4-o’clock meridians. A total of 184 patients were included, respectively 106 underwent PnR and 78 SB. Follow-up time was 6 months. Results Final visual outcome did not differ significantly between the two procedures (P = 0.12). Single-procedure reattachment rate was significantly higher in SB (94%) than in PnR (68%) (P Conclusion SB has a higher single reattachment rate than PnR. However, final visual outcomes of both procedures are comparable. In selected cases, PnR can be repeated with a high successful rate.
- Published
- 2022
38. The Short-Term Results of Autologous Platelet-Rich Plasma as an Adjuvant to Re-Intervention in the Treatment of Refractory Full-Thickness Macular Holes
- Author
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Matilde Buzzi, Guglielmo Parisi, Paola Marolo, Francesco Gelormini, Mariantonia Ferrara, Raffaele Raimondi, Davide Allegrini, Tommaso Rossi, Michele Reibaldi, and Mario R. Romano
- Subjects
pars plana vitrectomy ,autologous platelet-rich plasma ,highly myopic full-thickness macular holes ,optic disc pit maculopathy ,General Medicine ,refractory full-thickness macular hole - Abstract
The purpose of this study was to investigate the short-term efficacy and safety of autologous platelet-rich plasma (a-PRP) as an adjuvant to revisional vitrectomy for refractory full-thickness macular holes (rFTMHs). We conducted a prospective, non-randomized interventional study including patients with rFTMH after a pars plana vitrectomy (PPV) with internal limiting membrane peeling and gas tamponade. We included 28 eyes from 27 patients with rFTMHs: 12 rFTMHs in highly myopic eyes (axial length greater than 26.5 mm or a refractive error greater than -6D or both); 12 large rFTMHs (minimum hole width > 400 μm); and 4 rFTMHs secondary to the optic disc pit. All patients underwent 25-G PPV with a-PRP, a median time of 3.5 ± 1.8 months after the primary repair. At the six-month follow-up, the overall rFTMH closure rate was 92.9%, distributed as follows: 11 out of 12 eyes (91.7%) in the highly myopic group, 11 out of 12 eyes (91.7%) in the large rFTMH group, and 4 out of 4 eyes (100%) in the optic disc pit group. Median best-corrected visual acuity significantly improved in all groups, in particular from 1.00 (interquartile range: 0.85 to 1.30) to 0.70 (0.40 to 0.85) LogMAR in the highly myopic group (p = 0.016), from 0.90 (0.70 to 1.49) to 0.40 (0.35 to 0.70) LogMAR in the large rFTMH group (p = 0.005), and from 0.90 (0.75 to 1.00) to 0.50 (0.28 to 0.65) LogMAR in the optic disc pit group. No intraoperative or postoperative complications were reported. In conclusion, a-PRP can be an effective adjuvant to PPV in the management of rFTMHs.
- Published
- 2023
39. Perfluorocarbon syndrome-a possible, overlooked source of fatal gas embolism following uveal-melanoma endoresection
- Author
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Heinrich Ruschen, Mario R. Romano, Mariantonia Ferrara, Graeme K. Loh, Louisa Wickham, Bertil E. Damato, and Lyndon da Cruz
- Subjects
Uveal Neoplasms ,Ophthalmology ,Fluorocarbons ,Humans ,Embolism, Air ,Melanoma - Published
- 2022
40. A simple mathematical model of retinal reattachment after scleral buckling
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Sasan Kheirandish, Rodolfo Repetto, Mario R. Romano, Mohammad M. Alishahi, Ali A. Golneshan, Omid Abouali, and Jan O. Pralits
- Subjects
fluid structure interaction ,retinal detachment ,ophthalmology ,Mechanical Engineering ,fluid structure interaction, retinal detachment, CFD, ophthalmology ,CFD - Published
- 2022
41. Tips to optimize digital education in ophthalmology: Results from ESASO survey
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Mariantonia Ferrara, Vito Romano, Claudio Iovino, Mustafa R Kadhim, Elon HC van Dijk, Camiel JF Boon, Piergiacomo Grassi, Sibel Demirel, Cristian Cartes, Mario R Romano, Aniruddha Agarwal, Francesco Aiello, Aseef Amed, Francesca Amoroso, Martina Angi, Adrian Au, Ernesto Bali, Aman Chandra, Gilda Cennamo, Michela Cennamo, Marco Coassin, Antonio Di Zazzo, Giulia Coco, Francesco Maria D'Alterio, Claudia Del Turco, Carlo La Spina, Roberto Dell'Omo, Pasquale Napolitano, Tito Fiore, Andrea Govetto, Nataliia Malachkova, Rodolfo Mastropasqua, Francesco Matarazzo, Gerard McGowan, Michele Reibaldi, Robert Rejdak, Catherine Dianne Reyes-Delfino, Carlos Rocha-de-Lossada, Davide Romano, Francesca Romano, Luca Rombetto, Tommaso Rossi, Vincenzo Scorcia, David Steel, Mario Toro, Xavier Valldeperas, Jose L Vallejo-Garcia, Demetrios Vavvas, Agostino S Vaiano, Dinah Zur, Ophthalmology, ANS - Complex Trait Genetics, Ferrara, Mariantonia, Romano, Vito, Iovino, Claudio, R Kadhim, Mustafa, Hc van Dijk, Elon, Jf Boon, Camiel, Grassi, Piergiacomo, Demirel, Sibel, Cartes, Cristian, R Romano, Mario, Kadhim, Mustafa R, van Dijk, Elon Hc, Boon, Camiel Jf, Romano, Mario, and Toro, Mario
- Subjects
ophthalmology ,ophthalmology training ,Digital education ,learning ,professional education ,survey ,teaching ,Settore MED/30 ,General Medicine - Abstract
Purpose To identify audience and faculty preferences to optimize digital education sessions in ophthalmology. Methods We distributed an online survey to ophthalmology trainees and specialists worldwide. The survey investigated respondents’ preferences on various findings of hypothetical digital educational sessions. Data were analyzed using descriptive statistics, Fisher's exact probability and ANOVA tests. Results The survey was completed by 655 respondents, from 53 different countries. According to most respondents, the optimal duration and timeframe for a valuable digital education session would be 30–60 min, without a break (52%), in the evening time-slot (6-8 p.m.) (45%) of a weekday (Monday-Thursday) (46%), regardless of age ( p-value = 0.84, 0.39, 0.89, respectively) and job position ( p-value = 0.31, 0.29, 0.08, respectively). The availability of webinars and recorded surgical videos/clinical cases, associated with live discussion, represented the most important opportunity of digital educational channels for 46% and 42% of respondents, respectively. Conclusion Appropriate planning of timing and structure of digital educational ophthalmology sessions may optimize their effectiveness. Using multiple e-learning formats may be helpful to ensure the continuity of learning activities, also in view of a long-term replacement of traditional in-person education.
- Published
- 2022
42. Where Are We with RPE Replacement Therapy? A Translational Review from the Ophthalmologist Perspective
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Raffaele Raimondi, Piero Zollet, Francesco Paolo De Rosa, Panagiotis Tsoutsanis, Matteo Stravalaci, Marianna Paulis, Antonio Inforzato, and Mario R. Romano
- Subjects
induced pluripotent stem cells ,QH301-705.5 ,age related macular degeneration ,Review ,Retinal Pigment Epithelium ,replacement ,Catalysis ,Translational Research, Biomedical ,Inorganic Chemistry ,Macular Degeneration ,Humans ,Physical and Theoretical Chemistry ,Biology (General) ,Molecular Biology ,QD1-999 ,Spectroscopy ,Clinical Trials as Topic ,Ophthalmologists ,retinal pigmented epithelium ,Organic Chemistry ,General Medicine ,embryonic stem cells ,eye diseases ,Computer Science Applications ,Stargardt disease ,Chemistry ,sense organs - Abstract
The retinal pigmented epithelium (RPE) plays a pivotal role in retinal homeostasis. It is therefore an interesting target to fill the unmet medical need of different retinal diseases, including age-related macular degeneration and Stargardt disease. RPE replacement therapy may use different cellular sources: induced pluripotent stem cells or embryonic stem cells. Cells can be transferred as suspension on a patch with different surgical approaches. Results are promising although based on very limited samples. In this review, we summarize the current progress of RPE replacement and provide a comparative assessment of different published approaches which may become standard of care in the future.
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- 2022
43. Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers
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Roberto dell’Omo, Mariaelena Filippelli, Gianni Virgili, Francesco Bandello, Giuseppe Querques, Paolo Lanzetta, Teresio Avitabile, Francesco Viola, Michele Reibaldi, Francesco Semeraro, Luciano Quaranta, Stanislao Rizzo, Edoardo Midena, Giuseppe Campagna, Ciro Costagliola, Paola Marolo, Carlo Enrico Traverso, Michele Iester, Carlo Alberto Cutolo, Claudio Azzolini, Simone Donati, Elias Premi, Paolo Nucci, Stela Vujosevic, Giovanni Staurenghi, Ferdinando Bottoni, Francesco Romano, Domenico Grosso, Enrico Borrelli, Riccardo Sacconi, Paolo Milella, Simone Ganci, Mario R. Romano, Gabriella Ricciardelli, Davide Allegrini, Marco Casaluci, Davide Romano, Giorgio Marchini, Francesca Chemello, Camilla Amantea, Rino Frisina, Elisabetta Pilotto, Raffaele Parrozzani, Daniele Veritti, Valentina Sarao, Tognetto Daniele, Massimo Busin, Francesco Parmeggiani, Katia De Nadai, Luca Furiosi, Rodolfo Mastropasqua, Bruno Battaglia, Matteo Gironi, Stefano Gandolfi, Enrico Luciani, Paolo Mora, Costantino Schiavi, Patrizia Bertaccini, Alessandro Finzi, Matilde Roda, Carlo Cagini, Marco Lupidi, Fabrizio Giansanti, Daniela Bacherini, Gianmarco Tosi, Elena De Benedetto, Marco Nardi, Michele Figus, Chiara Posarelli, Cesare Mariotti, Vittorio Pirani, Michele Nicolai, Stefano Bonini, Marco Coassin, Antonio Di Zazzo, Mariacristina Savastano, Alfonso Savastano, Gloria Gambini, Umberto De Vico, Leopoldo Spadea, Andrea Iannaccone, Carlo Nucci, Federico Ricci, Francesco Aiello, Gabriele Gallo Afflitto, Leonardo Mastropasqua, Giada D’Onofio, Federica Evangelista, Lorenza Brescia, Pasquale Napolitano, Paolo Polisena, Nicolina Gianfrancesco, Domenico Trivisonno, Francesco Petti, Francesca Simonelli, Settimio Rossi, Antonio Tartaglione, Nicola Rosa, Maddalena De Bernardo, Cristiana Iaculli, Anna Valeria Bux, Giulia Maggiore, Francesco Boscia, Giancarlo Sborgia, Maria Oliva Grassi, Vincenzo Scorcia, Giuseppe Giannaccare, Guglielmo Parisi, Salvatore Cillino, Francesco Alaimo, Pasquale Aragona, Alessandro Meduri, Antonio Pinna, Andrea Sollazzo, Enrico Peiretti, Emanuele Siotto, dell’Omo, Roberto, Filippelli, Mariaelena, Virgili, Gianni, Bandello, Francesco, Querques, Giuseppe, Lanzetta, Paolo, Avitabile, Teresio, Viola, Francesco, Reibaldi, Michele, Semeraro, Francesco, Quaranta, Luciano, Rizzo, Stanislao, Midena, Edoardo, Campagna, Giuseppe, Costagliola, Ciro, Marolo, Paola, Traverso, Carlo Enrico, Iester, Michele, Cutolo, Carlo Alberto, Azzolini, Claudio, Donati, Simone, Premi, Elia, Nucci, Paolo, Vujosevic, Stela, Staurenghi, Giovanni, Bottoni, Ferdinando, Romano, Francesco, Grosso, Domenico, Borrelli, Enrico, Sacconi, Riccardo, Milella, Paolo, Ganci, Simone, Romano, Mario R., Ricciardelli, Gabriella, Allegrini, Davide, Casaluci, Marco, Romano, Davide, Marchini, Giorgio, Chemello, Francesca, Amantea, Camilla, Frisina, Rino, Pilotto, Elisabetta, Parrozzani, Raffaele, Veritti, Daniele, Sarao, Valentina, Daniele, Tognetto, Busin, Massimo, Parmeggiani, Francesco, De Nadai, Katia, Furiosi, Luca, Mastropasqua, Rodolfo, Battaglia, Bruno, Gironi, Matteo, Gandolfi, Stefano, Luciani, Enrico, Mora, Paolo, Schiavi, Costantino, Bertaccini, Patrizia, Finzi, Alessandro, Roda, Matilde, Cagini, Carlo, Lupidi, Marco, Giansanti, Fabrizio, Bacherini, Daniela, Tosi, Gianmarco, De Benedetto, Elena, Nardi, Marco, Figus, Michele, Posarelli, Chiara, Mariotti, Cesare, Pirani, Vittorio, Nicolai, Michele, Bonini, Stefano, Coassin, Marco, Di Zazzo, Antonio, Savastano, Mariacristina, Savastano, Alfonso, Gambini, Gloria, Vico, Umberto De, Spadea, Leopoldo, Iannaccone, Andrea, Nucci, Carlo, Ricci, Federico, Aiello, Francesco, Afflitto, Gabriele Gallo, Mastropasqua, Leonardo, D’Onofio, Giada, Evangelista, Federica, Brescia, Lorenza, Napolitano, Pasquale, Polisena, Paolo, Gianfrancesco, Nicolina, Trivisonno, Domenico, Petti, Francesco, Simonelli, Francesca, Rossi, Settimio, Tartaglione, Antonio, Rosa, Nicola, Bernardo, Maddalena De, Iaculli, Cristiana, Valeria Bux, Anna, Maggiore, Giulia, Boscia, Francesco, Sborgia, Giancarlo, Grassi, Maria Oliva, Scorcia, Vincenzo, Giannaccare, Giuseppe, Parisi, Guglielmo, Cillino, Salvatore, Alaimo, Francesco, Aragona, Pasquale, Meduri, Alessandro, Pinna, Antonio, Sollazzo, Andrea, Peiretti, Enrico, Siotto, Emanuele, Dell'Omo, R., Filippelli, M., Virgili, G., Bandello, F., Querques, G., Lanzetta, P., Avitabile, T., Viola, F., Reibaldi, M., Semeraro, F., Quaranta, L., Rizzo, S., Midena, E., Campagna, G., Costagliola, C., Marolo, P., Traverso, C. E., Iester, M., Cutolo, C. A., Azzolini, C., Donati, S., Premi, E., Nucci, P., Vujosevic, S., Staurenghi, G., Bottoni, F., Romano, F., Grosso, D., Borrelli, E., Sacconi, R., Milella, P., Ganci, S., Romano, M. R., Ricciardelli, G., Allegrini, D., Casaluci, M., Romano, D., Marchini, G., Chemello, F., Amantea, C., Frisina, R., Pilotto, E., Parrozzani, R., Veritti, D., Sarao, V., Daniele, T., Busin, M., Parmeggiani, F., De Nadai, K., Furiosi, L., Mastropasqua, R., Battaglia, B., Gironi, M., Gandolfi, S., Luciani, E., Mora, P., Schiavi, C., Bertaccini, P., Finzi, A., Roda, M., Cagini, C., Lupidi, M., Giansanti, F., Bacherini, D., Tosi, G., De Benedetto, E., Nardi, M., Figus, M., Posarelli, C., Mariotti, C., Pirani, V., Nicolai, M., Bonini, S., Coassin, M., Di Zazzo, A., Savastano, M., Savastano, A., Gambini, G., Vico, U. D., Spadea, L., Iannaccone, A., Nucci, C., Ricci, F., Aiello, F., Afflitto, G. G., Mastropasqua, L., D'Onofio, G., Evangelista, F., Brescia, L., Napolitano, P., Polisena, P., Gianfrancesco, N., Trivisonno, D., Petti, F., Simonelli, F., Rossi, S., Tartaglione, A., Rosa, N., Bernardo, M. D., Iaculli, C., Valeria Bux, A., Maggiore, G., Boscia, F., Sborgia, G., Grassi, M. O., Scorcia, V., Giannaccare, G., Parisi, G., Cillino, S., Alaimo, F., Aragona, P., Meduri, A., Pinna, A., Sollazzo, A., Peiretti, E., and Siotto, E.
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medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,medicine.medical_treatment ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Trauma, phacoemulsification, glaucoma, retinal detachment, choroidal neovascular membranes, venous occlusive disease, corneal transplantation ,Trauma ,choroidal neovascular membranes ,retinal detachment ,Retrospective Studie ,Settore MED/30 ,medicine ,Retrospective analysis ,choroidal neovascular membrane ,Humans ,venous occlusive disease ,Retrospective Studies ,corneal transplantation ,glaucoma ,phacoemulsification ,Communicable Disease Control ,SARS-CoV-2 ,COVID-19 ,Retinal Detachment ,Settore MED/30 - Malattie Apparato Visivo ,business.industry ,Retinal detachment ,General Medicine ,Phacoemulsification ,Surgical procedures ,medicine.disease ,Surgery ,Ophthalmology ,business ,trauma ,Human - Abstract
Background/objectives: To compare the number of eye surgical procedures performed in Italy in the 2 months following the beginning of lockdown (study period) because of COVID-19 epidemic with those performed in the two earlier months of the same year (intra-year control) and in the period of 2019 corresponding to the lockdown (inter-year control). Methods: Retrospective analysis of surgical procedures carried out at 39 Academic hospitals. A distinction was made between elective and urgent procedures. Intravitreal injections were also considered. Percentages for all surgical procedures and incidence rate ratios (IRR) for rhegmatogenous retinal detachment (RRD) events were calculated. A p value Results: A total of 20,886 versus 55,259 and 56,640 patients underwent surgery during the lockdown versus intra-and inter-year control periods, respectively. During the lockdown, only 70% of patients for whom an operation/intravitreal injection was recommended, finally underwent surgery; the remaining patients did not attend because afraid of getting infected at the hospital (23%), taking public transportation (6.5%), or unavailable swabs (0.5%). Elective surgeries were reduced by 96.2% and 96.4%, urgent surgeries by 49.7% and 50.2%, and intravitreal injections by 48.5% and 48.6% in the lockdown period in comparison to intra-year and inter-year control periods, respectively. IRRs for RRDs during lockdown dropped significantly in comparison with intra- and inter-year control periods (CI: 0.65–0.80 and 0.61–0.75, respectively, p Conclusion: This study provides a quantitative analysis of the reduction of eye surgical procedures performed in Italy because of the COVID-19 epidemic.
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- 2022
44. The Long Pentraxin PTX3 as a New Biomarker and Pharmacological Target in Age-Related Macular Degeneration and Diabetic Retinopathy
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Matteo Stravalaci, Mariantonia Ferrara, Varun Pathak, Francesca Davi, Barbara Bottazzi, Alberto Mantovani, Reinhold J. Medina, Mario R. Romano, and Antonio Inforzato
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Pharmacology ,genetic structures ,Mini Review ,RM1-950 ,eye diseases ,diabetic retinopathy ,SDG 3 - Good Health and Well-being ,inflammation ,Pharmacology (medical) ,complement ,Therapeutics. Pharmacology ,sense organs ,age-related macular degeneration ,PTX3 - Abstract
Age related macular degeneration (AMD) and diabetic retinopathy (DR) are multifactorial, neurodegenerative and inflammatory diseases of the eye primarily involving cellular and molecular components of the outer and inner blood-retina barriers (BRB), respectively. Largely contributed by genetic factors, particularly polymorphisms in complement genes, AMD is a paradigm of retinal immune dysregulation. DR, a major complication of diabetes mellitus, typically presents with increased vascular permeability and occlusion of the retinal vasculature that leads, in the proliferative form of the disease, to neovascularization, a pathogenic trait shared with advanced AMD. In spite of distinct etiology and clinical manifestations, both pathologies share common drivers, such as chronic inflammation, either of immune (in AMD) or metabolic (in DR) origin, which initiates and propagates degeneration of the neural retina, yet the underlying mechanisms are still unclear. As a soluble pattern recognition molecule with complement regulatory functions and a marker of vascular damage, long pentraxin 3 (PTX3) is emerging as a novel player in ocular homeostasis and a potential pharmacological target in neurodegenerative disorders of the retina. Physiologically present in the human eye and induced in inflammatory conditions, this protein is strategically positioned at the BRB interface, where it acts as a “molecular trap” for complement, and modulates inflammation both in homeostatic and pathological conditions. Here, we discuss current viewpoints on PTX3 and retinal diseases, with a focus on AMD and DR, the roles therein proposed for this pentraxin, and their implications for the development of new therapeutic strategies.
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- 2022
45. The use of personal protective equipment in clinical ophthalmology during corona virus disease-2019: a review of international guidelines and literature
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D Wong, Kenneth K. W. Li, Samuela W. K. Tang, Raffaele Raimondi, Nelson K.F. Yip, Clara Montalbano, Alessio Montericcio, and Mario R. Romano
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Infectious Disease Transmission, Patient-to-Professional ,Internationality ,Pneumonia, Viral ,education ,Psychological intervention ,Eye protection ,Betacoronavirus ,03 medical and health sciences ,0302 clinical medicine ,Tier 2 network ,medicine ,Humans ,Outpatient clinic ,Infection control ,Pandemics ,Personal Protective Equipment ,Personal protective equipment ,Infection Control ,SARS-CoV-2 ,business.industry ,COVID-19 ,General Medicine ,medicine.disease ,Triage ,Ophthalmology ,Surgical mask ,Practice Guidelines as Topic ,030221 ophthalmology & optometry ,Medical emergency ,Coronavirus Infections ,business ,030217 neurology & neurosurgery - Abstract
Purpose of review The use of nonpharmaceutical interventions can prevent viral spread in COVID-19 pandemic and PPE forms a crucial part of this strategy. However, there are discrepancies in existing guidelines and a lack of consensus among ophthalmic communities. This review aims to identify general consensus and provides recommendation of PPE for most common ophthalmological scenarios. With a global shortage of PPE, extended use and reuse strategies are also discussed. Recent findings In this review, guidelines and resources were selected, based on a three-tier process. The first-tier resources were from international infection control organizations. The second-tier resources were from ophthalmological professional associations and colleges. The third-tier resources involved a PubMed search using the keywords 'COVID-19; coronavirus; personal protective equipment' performed on 1 May 2020. Non-English guidelines and literatures were excluded. Summary On the basis of our methodology, we included a total of 30 documents, including 5 resources from tier 1, 14 resources from tier 2 and 15 from tier 3. Different levels of protection are necessary. Whenever performing an aerosol generating procedure, maximum protection should be ensured, this includes FFP3 respirator, fluid resistant gown, goggles or face-shield and disposable gloves. Similar protection should be used for handling COVID-19-positive/suspected case but the use of FFP2 respirator is acceptable. During routine outpatient clinic in cases of negative triage, it is recommended to use ASTM III surgical mask, plastic apron, disposable gloves and eye protection with goggles or face-shield. Lastly, patients should be encouraged to wear surgical masks whenever possible.
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- 2020
46. Facing COVID-19 in Ophthalmology Department
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Mario R. Romano, Gabriella Ricciardelli, Martina Angi, Alessio Montericcio, Luca Pagano, Clara Montalbano, Davide Allegrini, Vito Romano, and Raffaele Raimondi
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Infectious Disease Transmission, Patient-to-Professional ,Coronavirus disease 2019 (COVID-19) ,Health Personnel ,Pneumonia, Viral ,Psychological intervention ,Disease Outbreaks ,Betacoronavirus ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Pandemic ,Humans ,Medicine ,Outpatient clinic ,guidelines ,Pandemics ,Personal Protective Equipment ,Personal protective equipment ,Coronavirus disease 2019 ,SARS-CoV-2 ,business.industry ,Postponement ,transmission ,COVID-19 ,medicine.disease ,Triage ,Sensory Systems ,Ophthalmology ,NPI ,ophthalmology ,030221 ophthalmology & optometry ,Medical emergency ,Coronavirus Infections ,business ,Risk assessment ,030217 neurology & neurosurgery - Abstract
Purpose: To provide useful guidelines, targeted at ophthalmology professionals, to minimize COVID-19 infection of both health-care workers and patients.Methods: In this review we present updated literature merged with our experience from hospitals in Bergamo, the epicenter of the COVID-19 European outbreak.Results: Non-pharmaceutical interventions, hygienic recommendations and personal protective equipment to contain viral spread as well as a suggested risk assessment for postponement of non-urgent cases should be applied in ophthalmologist activity. A triage for ophthalmic outpatient clinic is mandatory.Conclusion: Ophthalmology practice should be reorganized in order to face COVID-19.
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- 2020
47. Distinctive Mechanisms and Patterns of Exudative Versus Tractional Intraretinal Cystoid Spaces as Seen With Multimodal Imaging
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Mario R. Romano, David Sarraf, Adrian Au, Aude Couturier, Gianni Virgili, Jean-Pierre Hubschman, Andrea Govetto, Ismael Chehaibou, Christelle Grondin, and Ramin Tadayoni
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Male ,Fluorescein angiography ,genetic structures ,Ophthalmology & Optometry ,Multimodal Imaging ,Exudative macular edema ,Oct angiography ,80 and over ,Fluorescein Angiography ,Macular hole ,Tomography ,Aged, 80 and over ,medicine.diagnostic_test ,Optical Imaging ,OCT angiography ,Middle Aged ,myopic foveoschisis ,retinal vein occlusion ,Public Health and Health Services ,Biomedical Imaging ,Female ,Optical Coherence Tomography ,blue fundus autofluorescence ,Enface ,Irvine-Gass syndrome ,Tomography, Optical Coherence ,Adult ,medicine.medical_specialty ,Fundus Oculi ,Clinical Sciences ,cystoid spaces ,Macular Edema ,Retina ,Epiretinal membrane ,Optical coherence tomography ,Clinical Research ,Opthalmology and Optometry ,Ophthalmology ,medicine ,Humans ,age-related macular degeneration ,Aged ,Retrospective Studies ,Multimodal imaging ,vitreomacular traction ,Diabetic Retinopathy ,Lamellar macular hole ,business.industry ,Müller cell ,medicine.disease ,eye diseases ,Fundus autofluorescence ,OCT ,Multicenter study ,Optical Coherence ,Tractional macular edema ,sense organs ,business - Abstract
PurposeTo determine clear-cut distinctions between tractional and exudative intraretinal cystoid spaces subtypes.DesignRetrospective, multicenter, observational case series.MethodsA cohort of patients diagnosed with intraretinal cystoid spaces and imaged with optical coherence tomography (OCT), fluorescein angiography (FA), blue fundus autofluorescence (BFAF), en face OCT, and OCT angiography (OCT-A) was included in the study. All images were qualitatively and quantitatively evaluated.ResultsIn this study were included 72 eyes of 69 patients. Exudative intraretinal cystoid spaces (36/72 eyes, 50%) displayed a "petaloid" morphology as seen with en face OCT, FA, and BFAF. Tractional intraretinal cystoid spaces (24/72 eyes, 33.3%), displayed a radial "spoke-wheel" en face OCT pattern. There was no leakage with FA and BFAF did not reveal specific patterns. Eyes with full-thickness macular hole (FTMH, 12/72 eyes, 16.7%) displayed a "sunflower" en face OCT appearance. FTMH showed OCT, OCT-A, and BFAF features of both exudative and tractional cystoid spaces, but without any FA leakage. Inner nuclear layer (INL) thickness was significantly lower in tractional cystoid spaces (P < .001). There were a greater number of INL cystoid spaces in both the exudative and FTMH subgroups (P= .001). The surface area of INL cystoid spaces was significantly lower in the tractional subgroup (P < .001). There was a significant reduction of the microvascular density in eyes with exudative vs tractional (P= .002) and FTMH (P < .001) subgroups.ConclusionsExudative and tractional intraretinal cystoid spaces displayed characteristic multimodal imaging features and they may represent 2 different pathologic conditions with equally different clinical implications.
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- 2020
48. Genetic Aspects of Age-Related Macular Degeneration and Their Therapeutic Potential
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Elisa Stradiotto, Davide Allegrini, Giovanni Fossati, Raffaele Raimondi, Tania Sorrentino, Domenico Tripepi, Gianmaria Barone, Antonio Inforzato, and Mario R. Romano
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Polymorphism, Genetic ,Organic Chemistry ,Angiogenesis Inhibitors ,Complement System Proteins ,General Medicine ,Polymorphism, Single Nucleotide ,Catalysis ,Computer Science Applications ,Inorganic Chemistry ,Macular Degeneration ,Humans ,Physical and Theoretical Chemistry ,Molecular Biology ,Spectroscopy - Abstract
Age-related macular degeneration (AMD) is a complex and multifactorial disease, resulting from the interaction of environmental and genetic factors. The continuous discovery of associations between genetic polymorphisms and AMD gives reason for the pivotal role attributed to the genetic component to its development. In that light, genetic tests and polygenic scores have been created to predict the risk of development and response to therapy. Still, none of them have yet been validated. Furthermore, there is no evidence from a clinical trial that the determination of the individual genetic structure can improve treatment outcomes. In this comprehensive review, we summarize the polymorphisms of the main pathogenetic ways involved in AMD development to identify which of them constitutes a potential therapeutic target. As complement overactivation plays a major role, the modulation of targeted complement proteins seems to be a promising therapeutic approach. Herein, we summarize the complement-modulating molecules now undergoing clinical trials, enlightening those in an advanced phase of trial. Gene therapy is a potential innovative one-time treatment, and its relevance is quickly evolving in the field of retinal diseases. We describe the state of the art of gene therapies now undergoing clinical trials both in the field of complement-suppressors and that of anti-VEGF.
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- 2022
49. Macular Microvascular Modifications in Progressive Lamellar Macular Holes
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Piero Zollet, Alessandra Nembri, Davide Allegrini, Filippo Confalonieri, Emanuele Crincoli, Mario R. Romano, and Fiammetta Catania
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Medicine (General) ,medicine.medical_specialty ,Capillary plexus ,genetic structures ,Clinical Biochemistry ,Last follow up ,retinal microvasculature ,Article ,chemistry.chemical_compound ,R5-920 ,Oct angiography ,Optical coherence tomography ,oct angiography ,Muller cells ,Ophthalmology ,Medicine ,neurovascular unit ,medicine.diagnostic_test ,business.industry ,lamellar macular hole ,Retinal ,Neurovascular bundle ,eye diseases ,chemistry ,Angiography ,sense organs ,business ,Perfusion - Abstract
Lamellar macular holes (LMHs) may show morphological and functional deterioration over time, yet no definite prognostic factor for progression has been identified. Since neurovascular retinal unit impairment may take part in neurodegeneration, we compare progressive LMHs to stable ones in optical coherence tomography (OCT) angiography parameters. Methods: OCT B scans of eyes with LMH were analyzed to detect the presence of tissue loss (TL) over time, allowing us to identify a TL group and a stable (ST) group (14 patients each). The best corrected visual acuity (BCVA) at each considered imaging time point was collected. Lastly, patients underwent macular OCT angiography. Results: BCVA at last follow up was significantly reduced in the TL group compared to both the ST group and TL group baseline assessment. SCP foveal vessel density (VD), SCP and deep capillary plexus (DCP) perfusion density (PD) and parafoveal PD were lower in the TL group. Linear correlations between quantitative TL over time and parafoveal PD in SCP and between the speed of TL and BCVA variation during follow up were also detected. Conclusions: TL in LMHs is associated with both OCT angiography modifications and BCVA deterioration over time. We suggest these findings to be a manifestation of foveal Muller cell impairment in progressive LMHs.
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- 2021
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50. Management of refractory and recurrent macular holes: A comprehensive review
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Mario R Romano, Tommaso Rossi, Alfredo Borgia, Fiammetta Catania, Tania Sorrentino, and Mariantonia Ferrara
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Ophthalmology ,Treatment Outcome ,Vitrectomy ,Humans ,Retinal Perforations ,Retina ,Tomography, Optical Coherence ,Retrospective Studies - Abstract
The primary repair of full-thickness macular holes (FTMHs) through pars plana vitrectomy with internal limiting membrane peeling and gas tamponade is the current standard of practice and offers a high closure rate of approximately 90%. On the contrary, the surgical management of refractory (or persistent) and recurrent FTMHs is still a challenging and controversial topic in vitreoretinal surgery as multiple options have been suggested, particularly over the last few years, with no consensus regarding any appropriate selection criteria or the best surgical option. Moreover, the presence of various case series / interventional studies presenting comparable outcomes, as well as the absence of studies with a direct comparison of different surgical techniques, may result in confusion. We provide a structured and comprehensive overview of the different surgical options currently available for the secondary repair of refractory and recurrent FTMHs. In addition to an update on epidemiology, diagnosis and description of the surgical steps, we highlight the evidence available to support each of the described surgical techniques, specifically focusing on the presumed mechanisms of hole closure, advantages, and known prognostic factors.
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- 2021
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