15 results on '"Pacente, L"'
Search Results
2. Corneal UV Protective Effects of a Topical Antioxidant Formulation: A Pilot Study on In Vivo Rabbits
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Germano Guerra, Marisa Palazzo, Lubomir Ondruška, Ciro Caruso, Michele Rinaldi, Francesco Vizzarri, Ciro Costagliola, Francesco Merolla, Luigi Pacente, Palazzo, M, Vizzarri, F, Ondruška, L, Rinaldi, M, Pacente, L, Guerra, G, Merolla, F, Caruso, C, Costagliola, C, Palazzo, M., Vizzarri, F., Ondruska, L., Rinaldi, M., Pacente, L., Guerra, G., Merolla, F., Caruso, C., and Costagliola, C.
- Subjects
0301 basic medicine ,Male ,Antioxidant ,medicine.medical_treatment ,alpha-Tocopherol ,Riboflavin ,Pilot Projects ,vitamin E ,Antioxidants ,lcsh:Chemistry ,chemistry.chemical_compound ,0302 clinical medicine ,Edema ,Cornea ,heterocyclic compounds ,Cornea protection ,D-α-tocopherol polyethylene glycol succinate (TPGS) ,Topic shielding formulation ,UV damage ,Vitamin E ,lcsh:QH301-705.5 ,Spectroscopy ,Chemistry ,digestive, oral, and skin physiology ,food and beverages ,General Medicine ,Computer Science Applications ,Radiation Injuries, Experimental ,medicine.anatomical_structure ,Rabbits ,medicine.symptom ,Swelling ,topic shielding formulation ,medicine.medical_specialty ,Ultraviolet Rays ,cornea protection ,Radiation-Protective Agents ,Polyethylene glycol ,Catalysis ,Article ,Inorganic Chemistry ,03 medical and health sciences ,In vivo ,Ophthalmology ,medicine ,Animals ,Physical and Theoretical Chemistry ,riboflavin ,Molecular Biology ,Organic Chemistry ,eye diseases ,030104 developmental biology ,lcsh:Biology (General) ,lcsh:QD1-999 ,030221 ophthalmology & optometry ,sense organs ,Corneal Injuries - Abstract
This study aimed to evaluate the protective effect of a topical antioxidant and ultraviolet (UV) shielding action formulation containing riboflavin and D-&alpha, tocopherol polyethylene glycol succinate (TPGS) vitamin E against corneal UV-induced damage in vivo rabbit eyes. In vivo experiments were performed using male albino rabbits, which were divided into four groups. The control group (CG) did not receive any UV irradiation, the first group (IG) was irradiated with a UV-B&minus, UV-A lamp for 30 min, the second (G30) and third (G60) groups received UV irradiation for 30 and 60 min, respectively, and were topically treated with one drop of the antioxidant and shielding formulation every 15 min, starting one hour before irradiation, until the end of UV exposure. The cornea of the IG group showed irregular thickening, detachment of residual fragments of the Descemet membrane, stromal fluid swelling with consequent collagen fiber disorganization and disruption, and inflammation. The cornea of the G30 group showed edema, a mild thickening of the Descemet membrane without fibrillar collagen disruption and focal discoloration, or inflammation. In the G60 group, the cornea showed a more severe thickening, a more abundant fluid accumulation underneath the Descemet membrane with focal detachment, and no signs of severe tissue alterations, as were recorded in the IG group. Our results demonstrate that topical application of eye drops containing riboflavin and TPGS vitamin E counteracts UV corneal injury in exposed rabbits.
- Published
- 2020
3. Effectiveness and Safety of Topical Chlorhexidine and Vitamin E TPGS in the Treatment of Acanthamoeba Keratitis: A Survey on 29 Cases
- Author
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Daniela Eletto, Salvatore Troisi, Michele Rinaldi, Roberto dell'Omo, Francesco Semeraro, Luigi Pacente, Ciro Caruso, Ciro Costagliola, Caruso, C., Eletto, D., Rinaldi, M., Pacente, L., Troisi, S., Semeraro, F., Dell'Omo, R., and Costagliola, C.
- Subjects
medicine.medical_specialty ,Visual acuity ,genetic structures ,Drug delivery system ,Ocular infection ,Corneal inflammation ,030308 mycology & parasitology ,03 medical and health sciences ,Vitamin E-TPGS ,drug delivery systems ,0302 clinical medicine ,Ophthalmology ,medicine ,ocular infections ,Corneal Scar ,Every Two Hours ,0303 health sciences ,Acanthamoeba keratitis ,vitamin E TPGS ,business.industry ,Chlorhexidine ,chlorhexidine ,General Medicine ,medicine.disease ,eye diseases ,030221 ophthalmology & optometry ,sense organs ,medicine.symptom ,business ,Acanthamoeba keratiti ,medicine.drug ,Case series - Abstract
This study aimed to test the effectiveness of a solution of chlorhexidine (CHX) and D-α-tocopheryl polyethylene glycol succinate (Vitamin E TPGS or TPGS) in the treatment of Acanthamoeba keratitis (AK) via a prospective, interventional case series study. Twenty-nine consecutive patients with AK were enrolled. At baseline, best-corrected visual acuity (BCVA), slit lamp examination, confocal microscopy, and polymerase chain reaction (PCR) were performed. Topical therapy with CHX 0.02% and VE-TPGS 0.2% was administered hourly/24 h for the first day, hourly in the daytime for the next three days, and finally, every two hours in the daytime up to one month. BCVA and ocular inflammation were recorded after two weeks, four weeks, and three months from baseline. Mean logMAR BCVA significantly improved at two weeks (0.78) compared to baseline (1.76), remaining stable over time (0.80 at four weeks, 0.77 at three months). Ocular inflammation improved in 14 eyes at 2 weeks, with further slow improvements in all cases. At three months, no patient had signs of corneal inflammation. The presence of corneal scars was first recorded at the two-week follow-up, with an enlargement at the four-week follow-up. At the three-month follow-up, 19 eyes still showed corneal opacities. In conclusion, the tested solution was shown to be effective for the treatment of AK. Furthermore, it might represent a good first-line treatment.
- Published
- 2020
4. Intraocular pressure reduction with once-a-day application of a new prostaglandin eye drop: a pilot placebo-controlled study in 12 patients
- Author
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Pasquale Troiano, Ciro Costagliola, Carmine Ostacolo, Silvia Bartollino, Luigi Pacente, Luca Domenico D'Andrea, Ciro Caruso, Caruso, C., Pacente, L., Troiano, P., Ostacolo, C., D'Andrea, L., Bartollino, S., and Costagliola, C.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Intraocular pressure ,genetic structures ,medicine.medical_treatment ,Placebo-controlled study ,Prostaglandin ,Glaucoma ,Pilot Projects ,Placebo ,Drug Administration Schedule ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Double-Blind Method ,Ophthalmology ,Normal tension glaucoma ,medicine ,Humans ,15-keto fluprostenol ,IOP ,NTG ,Intraocular Pressure ,Aged ,Dose-Response Relationship, Drug ,business.industry ,Eye drop ,Middle Aged ,medicine.disease ,eye diseases ,Treatment Outcome ,chemistry ,Prostaglandins F, Synthetic ,030221 ophthalmology & optometry ,Female ,sense organs ,Travoprost ,Ophthalmic Solutions ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Purpose: To assess the ocular hypotensive effect of 15-keto fluprostenol, the oxidized metabolite of travoprost, on glaucoma patients, through a randomized double-masked placebo-controlled study. Methods: Twelve patients with ocular normal tension glaucoma (NTG) (intraocular pressure [IOP] < 22 mmHg) were enrolled. In order to ensure patient compliance to treatment, all study subjects were hospitalized. In each patient, the eye to be submitted to the treatments was randomly chosen. After hospital admission (day 1), those patients received for 5 days at 8 P.M. either one drop of 15-keto fluprostenol (35 μg/ml) or one drop of placebo. IOP evaluation was performed within 8 A.M. and 8 P.M. for 6 days. Furthermore, we performed a determination of cardiovascular parameters before and after the treatments. Results: Starting with the first IOP measurement after the first treatment (8 A.M. on day 2), IOP was reduced of about 14% in the eyes treated 15-keto fluprostenol, in comparison with baseline IOP values of 15-keto fluprostenol-treated patients. The IOP reduction in the 15-keto fluprostenol-treated group was significantly compared to placebo group (p < 0.05) starting from day 3 till day 6 of the study. Except for mild hyperemia in one 15-keto fluprostenol-treated eye, no other side effects were observed or reported by the enrolled patients. Conclusions: The travoprost metabolite 15-keto fluprostenol was effective in decrease IOP and maintained IOP reduction along 5 days of treatment. The 15-keto fluprostenol can be developed as a good candidate for once-a-day NTG patients’ treatment.
- Published
- 2020
5. Valsalva retinopathy associated with a congenital retinal macrovessel
- Author
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Giovanni Greco, Giuseppe de Crecchio, Maria Cristina Alfieri, Luigi Pacente, DE CRECCHIO, Giuseppe, Pacente, L, Alfieri, Mc, and Greco, G. M.
- Subjects
Male ,medicine.medical_specialty ,Retinal Vein ,Visual acuity ,Adolescent ,genetic structures ,Valsalva Maneuver ,medicine.medical_treatment ,Eye disease ,Visual Acuity ,Retinal Diseases ,Ophthalmology ,medicine ,Valsalva maneuver ,Humans ,Eye Abnormalities ,Fluorescein Angiography ,Retina ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Fluorescein angiography ,eye diseases ,Surgery ,Choroidal neovascularization ,medicine.anatomical_structure ,sense organs ,medicine.symptom ,business ,Retinopathy - Abstract
AN 18- YEAR-OLD healthy white man reported a sudden decrease in central visual acuity in his right eye after physical exertion, probably combined with a Valsalva maneuver, while repairing his car. He did not report other symptoms and was not taking systemic medications. Best-corrected visual acuity was 20/600 OD and 20/20 OS. Anterior segment examination and intraocular pressures were normal. Ophthalmoscopic examination of the right eye disclosed the presence of an anomalous retinal vein extending along the papillomacular bundle through the foveal avascular zone and temporally. A preretinal hemorrhage overlaid the fovea and partially obscured the underlying a nomalous r etinal v ein (Figure 1). Fluorescein angiography of the right eye demonstrated blocked fluorescence from this preretinal hemorrhage (Figure 2). No evidence of choroidal neovascularization was observed. On follow-up examination 5 weeks later, the visual acuity had improved to 20/20 OD. The preretinal hemorrhage had completely resorbed, allowing examination of the underlying retinal vasculature. Fluorescein angiography at this time disclosed the anomalous vein crossing over the foveal avascular zone, and the vein appeared normal on angiographic examination (Figure 3 and Figure 4). There is no evidence of an arteriovenous anastomosis or late leakage.
- Published
- 2000
6. Treatment of progressive myopia with 0.01% Atropine in children and adolescents: an Italian 4-year follow-up study.
- Author
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Di Meglio M, Giunta P, Rechichi M, Trofa A, Galantuomo G, Galantuomo N, Palmieri S, Pacente L, and Salducci M
- Subjects
- Humans, Child, Follow-Up Studies, Adolescent, Male, Female, Italy, Mydriatics administration & dosage, Mydriatics therapeutic use, Myopia drug therapy, Ophthalmic Solutions administration & dosage, Ophthalmic Solutions therapeutic use, Myopia, Degenerative drug therapy, Time Factors, Refraction, Ocular drug effects, Treatment Outcome, Atropine administration & dosage, Atropine therapeutic use, Disease Progression
- Abstract
Purpose: To assess the effectiveness of atropine 0.01% in slowing the progression of myopia in young patients., Methods: 2,387 patients with progressive myopia (more than -0.50 spherical diopters ‹D› increased in the last year) were enrolled. They received, every evening, one drop of atropine 0.01% in each eye. Refraction was then measured at baseline (T0) and once a year (T1, T2, T3, T4) for a 4-years follow-up period, and compared with a non-treated control group., Results: A reduction in the myopic progression was observed in the treated group respect to the control one. The average spherical refraction after 4 years increased by 27.06% in the treated group versus 241% of the control one. The difference in spherical increase between the two groups respect to time 0 was appreciable already at the first control, (T1 -T0, -0.21D vs. -1D) and continued to increase for all the 4-years follow-up period (T2-T0, -0.38D vs. -1.91D;T3-T0, -0.52D vs. -2.74D; T4-T0, -0.73D vs. -3.63D, respectively). It was always significant (P<0.01). Compared to the previous year, the average spherical increase was quite stable in the two groups (0.17 vs. 0.87, respectively). No significant tachyphylaxis or adverse effects were observed throughout the examination period., Conclusions: 0.01% atropine was effective in slowing the progression of myopia in the treated group vs. control one. The clinical effect was noticeable already from the first control, and continued for all the observation period. The results of this study agree with those already reported in literature, and confirm the validity of this treatment.
- Published
- 2024
- Full Text
- View/download PDF
7. Effectiveness and Safety of Topical Chlorhexidine and Vitamin E TPGS in the Treatment of Acanthamoeba Keratitis: A Survey on 29 Cases.
- Author
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Caruso C, Eletto D, Rinaldi M, Pacente L, Troisi S, Semeraro F, dell'Omo R, and Costagliola C
- Abstract
This study aimed to test the effectiveness of a solution of chlorhexidine (CHX) and D-α-tocopheryl polyethylene glycol succinate (Vitamin E TPGS or TPGS) in the treatment of Acanthamoeba keratitis (AK) via a prospective, interventional case series study. Twenty-nine consecutive patients with AK were enrolled. At baseline, best-corrected visual acuity (BCVA), slit lamp examination, confocal microscopy, and polymerase chain reaction (PCR) were performed. Topical therapy with CHX 0.02% and VE-TPGS 0.2% was administered hourly/24 h for the first day, hourly in the daytime for the next three days, and finally, every two hours in the daytime up to one month. BCVA and ocular inflammation were recorded after two weeks, four weeks, and three months from baseline. Mean logMAR BCVA significantly improved at two weeks (0.78) compared to baseline (1.76), remaining stable over time (0.80 at four weeks, 0.77 at three months). Ocular inflammation improved in 14 eyes at 2 weeks, with further slow improvements in all cases. At three months, no patient had signs of corneal inflammation. The presence of corneal scars was first recorded at the two-week follow-up, with an enlargement at the four-week follow-up. At the three-month follow-up, 19 eyes still showed corneal opacities. In conclusion, the tested solution was shown to be effective for the treatment of AK. Furthermore, it might represent a good first-line treatment.
- Published
- 2020
- Full Text
- View/download PDF
8. Corneal UV Protective Effects of a Topical Antioxidant Formulation: A Pilot Study on In Vivo Rabbits.
- Author
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Palazzo M, Vizzarri F, Ondruška L, Rinaldi M, Pacente L, Guerra G, Merolla F, Caruso C, and Costagliola C
- Subjects
- Animals, Male, Pilot Projects, Rabbits, Radiation-Protective Agents therapeutic use, Ultraviolet Rays adverse effects, Antioxidants therapeutic use, Corneal Injuries drug therapy, Radiation Injuries, Experimental drug therapy, Riboflavin therapeutic use, alpha-Tocopherol therapeutic use
- Abstract
This study aimed to evaluate the protective effect of a topical antioxidant and ultraviolet (UV) shielding action formulation containing riboflavin and D-α-tocopherol polyethylene glycol succinate (TPGS) vitamin E against corneal UV-induced damage in vivo rabbit eyes. In vivo experiments were performed using male albino rabbits, which were divided into four groups. The control group (CG) did not receive any UV irradiation; the first group (IG) was irradiated with a UV-B-UV-A lamp for 30 min; the second (G30) and third (G60) groups received UV irradiation for 30 and 60 min, respectively, and were topically treated with one drop of the antioxidant and shielding formulation every 15 min, starting one hour before irradiation, until the end of UV exposure. The cornea of the IG group showed irregular thickening, detachment of residual fragments of the Descemet membrane, stromal fluid swelling with consequent collagen fiber disorganization and disruption, and inflammation. The cornea of the G30 group showed edema, a mild thickening of the Descemet membrane without fibrillar collagen disruption and focal discoloration, or inflammation. In the G60 group, the cornea showed a more severe thickening, a more abundant fluid accumulation underneath the Descemet membrane with focal detachment, and no signs of severe tissue alterations, as were recorded in the IG group. Our results demonstrate that topical application of eye drops containing riboflavin and TPGS vitamin E counteracts UV corneal injury in exposed rabbits.
- Published
- 2020
- Full Text
- View/download PDF
9. A Novel Vitamin E TPGS-Based Formulation Enhances Chlorhexidine Bioavailability in Corneal Layers.
- Author
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Caruso C, Porta A, Tosco A, Eletto D, Pacente L, Bartollino S, and Costagliola C
- Abstract
Keratitis is a severe condition characterized by inflammation of the cornea following a local trauma. The most common ocular disease is the bacterial one, which requires an antibiotic treatment. The major limitation of this therapy is the resistance of the antibiotic. For this reason, alternative procedures have been developed and consist of antimicrobial molecules. One of the most used is the chlorhexidine gluconate, which has shown activity versus Gram-positive and Gram-negative bacteria and fungi. In addition to its efficiency, chlorhexidine shows low toxicity levels for mammalian cells and is a low-cost molecule. Despite its multiple benefits, chlorhexidine, if used at concentrations higher than 0.02% ( w/w ), can cause local eye irritation. Additionally, its poor penetrability through the cornea makes necessary frequent instillation of eye drops for a prolonged time. Due to these limitations, alternative drug delivery strategies are required. Here, we report a novel formulation based on the combination of d-alpha-tocopherol polyethylene glycol 1000 succinate with chlorhexidine, which results in higher accumulation of the drug in human corneas measured by liquid chromatography and strong antimicrobial activity. Moreover, this formulation does not cause any toxic effect on human cells and is well tolerated by rabbit eyes. Therefore this novel formulation represents a good candidate for the treatment of keratitis that overcomes the risk of antibiotic resistance.
- Published
- 2020
- Full Text
- View/download PDF
10. Intraocular pressure reduction with once-a-day application of a new prostaglandin eye drop: a pilot placebo-controlled study in 12 patients.
- Author
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Caruso C, Pacente L, Troiano P, Ostacolo C, D'Andrea L, Bartollino S, and Costagliola C
- Subjects
- Adult, Aged, Dose-Response Relationship, Drug, Double-Blind Method, Drug Administration Schedule, Female, Glaucoma physiopathology, Humans, Intraocular Pressure physiology, Male, Middle Aged, Ophthalmic Solutions administration & dosage, Pilot Projects, Treatment Outcome, Glaucoma drug therapy, Intraocular Pressure drug effects, Prostaglandins F, Synthetic administration & dosage
- Abstract
Purpose: To assess the ocular hypotensive effect of 15-keto fluprostenol, the oxidized metabolite of travoprost, on glaucoma patients, through a randomized double-masked placebo-controlled study., Methods: Twelve patients with ocular normal tension glaucoma (NTG) (intraocular pressure [IOP] < 22 mmHg) were enrolled. In order to ensure patient compliance to treatment, all study subjects were hospitalized. In each patient, the eye to be submitted to the treatments was randomly chosen. After hospital admission (day 1), those patients received for 5 days at 8 P.M. either one drop of 15-keto fluprostenol (35 μg/ml) or one drop of placebo. IOP evaluation was performed within 8 A.M. and 8 P.M. for 6 days. Furthermore, we performed a determination of cardiovascular parameters before and after the treatments., Results: Starting with the first IOP measurement after the first treatment (8 A.M. on day 2), IOP was reduced of about 14% in the eyes treated 15-keto fluprostenol, in comparison with baseline IOP values of 15-keto fluprostenol-treated patients. The IOP reduction in the 15-keto fluprostenol-treated group was significantly compared to placebo group (p < 0.05) starting from day 3 till day 6 of the study. Except for mild hyperemia in one 15-keto fluprostenol-treated eye, no other side effects were observed or reported by the enrolled patients., Conclusions: The travoprost metabolite 15-keto fluprostenol was effective in decrease IOP and maintained IOP reduction along 5 days of treatment. The 15-keto fluprostenol can be developed as a good candidate for once-a-day NTG patients' treatment.
- Published
- 2020
- Full Text
- View/download PDF
11. Topography and Pachymetry Guided, Rapid Epi-on Corneal Cross-Linking for Keratoconus: 7-year Study Results.
- Author
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Caruso C, Epstein RL, Troiano P, Ostacolo C, Barbaro G, Pacente L, Bartollino S, and Costagliola C
- Subjects
- Adult, Female, Follow-Up Studies, Humans, Keratoconus pathology, Male, Photosensitizing Agents therapeutic use, Prospective Studies, Refraction, Ocular, Riboflavin therapeutic use, Therapy, Computer-Assisted methods, Time Factors, Ultraviolet Rays, Visual Acuity, Collagen therapeutic use, Cornea diagnostic imaging, Corneal Pachymetry methods, Corneal Topography methods, Cross-Linking Reagents therapeutic use, Keratoconus drug therapy, Photochemotherapy methods
- Abstract
Purpose: To evaluate custom fast cross-linking (cfCXL) treatment of keratoconus., Methods: "Custom fast cross-linking" or "cfCXL" is a keratoconus treatment algorithm featuring no epithelial disruption, 15 minutes of corneal presoaking with a riboflavin-vitamin E TPGS solution, and a 370-nm ultraviolet A radiation beam centered on the most highly curved corneal region. Ultraviolet A radiation beam fluence, total energy, and exposure time are significantly less than those in the Dresden protocol. In this study, refraction, spectacle-corrected distance visual acuity, Kmax, and corneal hysteresis were monitored in 81 eyes of 81 patients for 7 years with 100% follow-up. Pretreatment Kmax and patient age averaged 53.01 ± 4.87 D and 25.9 ± 4.7 years, respectively., Results: Average refractive cylinder magnitude was reduced by 26.1% at 1 month postoperatively and by 44.2% at 7 years postoperatively. Logarithm of the minimum angle of resolution average spectacle-corrected distance visual acuity (best spectacle-corrected distance visual acuity) improved from +0.26 ± 0.34 (20/36.4) to +0.15 ± 0.23 (20/28.25), +0.05 ± 0.20 (20/22.4), and +0.06 ± 0.20 (20/22.96) at 1 month, 1 year, and 7 years postoperatively, respectively. Best spectacle-corrected distance visual acuity improved in 54.3%, 74.1%, 84.0%, 87.7%, 84.0%, 84.0%, and 82.7% of patients at postoperative months 1, 3, 6, 12, 24, 48, and 84, respectively. Kmax did not increase in 96.3% of patients at 1 month, 97.5% at 1 year, and 98.8% at 7 years postoperatively, with average corneal apex flattening at 1 month and 7 years of -2.79 ± 1.70 D and -4.00 ± 2.40 D, respectively., Conclusions: Custom fast cross-linking, epi-on, rapid, narrowed beam apex-centered treatment of keratoconus with riboflavin-vitamin E TPGS produced a significant, rapid, and lasting cone progression stoppage, astigmatism reduction, and visual acuity improvement.
- Published
- 2020
- Full Text
- View/download PDF
12. Customized Corneal Cross-Linking-A Mathematical Model.
- Author
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Caruso C, Epstein RL, Ostacolo C, Pacente L, Troisi S, and Barbaro G
- Subjects
- Collagen drug effects, Collagen radiation effects, Humans, Models, Theoretical, Photochemotherapy adverse effects, Reproducibility of Results, Cornea drug effects, Cornea radiation effects, Cross-Linking Reagents pharmacology, Photochemotherapy methods, Photosensitizing Agents pharmacology, Photosensitizing Agents therapeutic use, Riboflavin pharmacology, Ultraviolet Rays
- Abstract
Purpose: To improve the safety, reproducibility, and depth of effect of corneal cross-linking with the ultraviolet A (UV-A) exposure time and fluence customized according to the corneal thickness., Methods: Twelve human corneas were used for the experimental protocol. They were soaked using a transepithelial (EPI-ON) technique using riboflavin with the permeation enhancer vitamin E-tocopheryl polyethylene glycol succinate. The corneas were then placed on microscope slides and irradiated at 3 mW/cm for 30 minutes. The UV-A output parameters were measured to build a new equation describing the time-dependent loss of endothelial protection induced by riboflavin during cross-linking, as well as a pachymetry-dependent and exposure time-dependent prescription for input UV-A fluence. The proposed equation was used to establish graphs prescribing the maximum UV-A fluence input versus exposure time that always maintains corneal endothelium exposure below toxicity limits., Results: Analysis modifying the Lambert-Beer law for riboflavin oxidation leads to graphs of the maximum safe level of UV-A radiation fluence versus the time applied and thickness of the treated cornea. These graphs prescribe UV-A fluence levels below 1.8 mW/cm for corneas of thickness 540 μm down to 1.2 mW/cm for corneas of thickness 350 μm. Irradiation times are typically below 15 minutes., Conclusions: The experimental and mathematical analyses establish the basis for graphs that prescribe maximum safe fluence and UV-A exposure time for corneas of different thicknesses. Because this clinically tested protocol specifies a corneal surface clear of shielding riboflavin on the corneal surface during UV-A irradiation, it allows for shorter UV-A irradiation time and lower fluence than in the Dresden protocol.
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- 2017
- Full Text
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13. Corneal Cross-Linking: Evaluating the Potential for a Lower Power, Shorter Duration Treatment.
- Author
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Caruso C, Barbaro G, Epstein RL, Tronino D, Ostacolo C, Sacchi A, Pacente L, Del Prete A, Sala M, and Troisi S
- Subjects
- Animals, Biomechanical Phenomena, Collagen metabolism, Cornea metabolism, Corneal Stroma metabolism, Elastic Modulus, Elasticity, Humans, Radiation Dosage, Radiation Monitoring, Swine, Time Factors, Cornea drug effects, Cross-Linking Reagents, Photosensitizing Agents administration & dosage, Riboflavin administration & dosage, Ultraviolet Rays
- Abstract
Purpose: To determine the cross-linking effect of a riboflavin ultraviolet-A (UV-A) corneal cross-linking treatment that is both shorter and has lower energy than the Dresden protocol., Methods: In a first experiment, 12 human corneas were presoaked with riboflavin and then irradiated with UV-A at 3 mW/cm after clearing the surface of riboflavin, with no added riboflavin during irradiation. Percent UV-A transmission through the corneas was measured at intervals up to 30 minutes. A second experiment involved 24 porcine corneas. Eight were de-epithelialized, presoaked in riboflavin for 30 minutes, and irradiated at 1.5 mW/cm for 10 minutes. An additional 8 were riboflavin treated and similarly irradiated, but with epithelium intact and a final 8 corneas were not treated. Young modulus was measured in all 24 corneas at the end of the experiment., Results: The first experiment showed essentially complete riboflavin oxidation after only 10 minutes. Based on these results, a shortened UV-A exposure cross-linking experiment was designed using a reduced UV-A fluence of 1.5 mW/cm, an endothelial exposure within safety limits in humans. With this protocol Young modulus was the same in the irradiated porcine corneas but with epithelium intact as in the untreated corneas. In contrast, Young modulus increased by a factor of 1.99 in the UV-A cross-linked corneas at 1.5 mW/cm for 10 minutes with the epithelium removed., Conclusions: A shorter, lower energy protocol than the Dresden protocol seems to provide a significant increase in Young modulus, similar to published results with higher energy, longer exposure protocols.
- Published
- 2016
- Full Text
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14. Enhancement of corneal permeation of riboflavin-5'-phosphate through vitamin E TPGS: a promising approach in corneal trans-epithelial cross linking treatment.
- Author
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Ostacolo C, Caruso C, Tronino D, Troisi S, Laneri S, Pacente L, Del Prete A, and Sacchi A
- Subjects
- Administration, Ophthalmic, Animals, Antioxidants pharmacokinetics, Antioxidants pharmacology, Biological Availability, Cornea ultrastructure, Corneal Topography methods, Corneal Topography statistics & numerical data, Cross-Linking Reagents administration & dosage, Cross-Linking Reagents chemistry, Cross-Linking Reagents pharmacology, Dextrans administration & dosage, Dextrans chemistry, Drug Carriers, Flavin Mononucleotide administration & dosage, Flavin Mononucleotide chemistry, Flavin Mononucleotide pharmacology, Humans, In Vitro Techniques, Polyethylene Glycols administration & dosage, Polyethylene Glycols chemistry, Prodrugs administration & dosage, Prodrugs chemistry, Prodrugs pharmacology, Swine, Vitamin E administration & dosage, Vitamin E chemistry, Cornea drug effects, Cross-Linking Reagents pharmacokinetics, Flavin Mononucleotide pharmacokinetics, Prodrugs pharmacokinetics, Vitamin E analogs & derivatives
- Abstract
Corneal accumulation of riboflavin-5'-phosphate (riboflavin) is an essential step in the so called corneal cross-linking (CXL), an elective therapy for the treatment of progressive keratoconus, corneal ectasia and irregular astigmatism. CXL is usually performed after surgical debridement of corneal epithelium, since it impedes the stromal penetration of riboflavin in a relatively short time. d-Alpha-tocopheryl poly(ethylene glycol) 1000 succinate (VE-TPGS) is an effective permeation enhancer used to increase adsorption of drugs trough different biological barriers. Moreover, belonging to the group of tocopherol pro-drugs, VE-TPGS exerts a protective effect on biological membrane against free-radical damage. The aim of this work is the evaluation of VE-TPGS effects on riboflavin corneal permeability, and the assessment of its protective effect against free-radicals generated during CXL procedures. Different solutions containing riboflavin (0.125% w/w), dextran (20.0% w/w) and increasing concentration of VE-TPGS were tested. Corneal permeation was evaluated in vitro by the use of modified Franz-cell type diffusion cells and freshly excised porcine corneas as barrier. The effect of VE-TPGS on riboflavin corneal penetration was compared with a standard commercial solution of riboflavin in dextran at different times. Accumulation experiments were conducted both on epithelized and non-epithelized corneas. Moreover, epithelized porcine corneas, treated with the tested solutions, were subjected to an in vitro CXL procedure versus non-epithelized corneas, treated with a commercial solution of riboflavin. Differences were measured by means of corneal rigidity using Young's modulus. The photo-protective effect of tested solutions on corneal epithelium was, finally, evaluated. CXL treatment was applied, in vitro, on human explanted corneas and resulting morphology of corneal epithelium was investigated by scanning electron microscopy., (Copyright © 2012 Elsevier B.V. All rights reserved.)
- Published
- 2013
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15. Valsalva retinopathy associated with a congenital retinal macrovessel.
- Author
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de Crecchio G, Pacente L, Alfieri MC, and Greco GM
- Subjects
- Adolescent, Eye Abnormalities diagnosis, Fluorescein Angiography, Humans, Male, Retinal Diseases diagnosis, Retinal Vein pathology, Visual Acuity, Eye Abnormalities etiology, Retinal Diseases etiology, Retinal Vein abnormalities, Valsalva Maneuver
- Published
- 2000
- Full Text
- View/download PDF
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