Adverse events associated with intraocular injection of anti-VEGF(bevacizumab) in retinal vein ccclusion: a case report

Introduction: Antiangiogenic agents are often administered for treatment of Branch Retinal Vein Occlusion (BRVO). Among them, Bevacizumab has noticeable antiangiogenic and antiedemigenic properties and possesses great capacity to penetrate the retinal tissue, particularly in pathological circumstances characterized by altered external or internal blood-retinal barrier.Bevacizumab has an optimal bio-efficacy based on inhibition of the activity of Vascular Endothelial Growth Factor (VEGF). Nonetheless, despite its efficacy, here we describe the adverse effects associated with intraocular injection of bevacizumab in a patient affected by retinal vein occlusion. Case presentation: We present a case report of an 11-year old Caucasian malesubject affected by BRVO in his left eye. The patient underwent an intra-vitreal (i.v.) injection of bevacizumab 100 (1.25 mg/0.05ml). After that, the patient was monitored over time through a series of analyses including Ocular Coherence Tomography, Fluorangiography, Bulbar Ultrasound, Angio MRI BCVA scores and Intra Ocular Pressure. Results: Immediately after the i.v. injection, the patient experienced a strong and relentless pain radiating from the left ocular orbit, caused by a serious and unexpected malignant glaucoma and phthisis bulbi. Furthermore, the patient did not show any sign of improvement in visual function in the follow-up and at last required an ophthalmic prosthesisas a result of a subatrophic and hypotonic eyeball. Conclusion: This case report suggests that i.v. injections of anti-VEGFs should be considered wit

Filariosi oculare: diagnosi e trattamento.

Gli autori riportano 2 casi di filariosi oculare i cui aspetti clinici variabili realizzano dei veri problemi diagnostici. In particolare il primo caso presentava una localizzazione cutanea palpebrale curato per più di sei mesi per calazio. Il secondo presentava una localizzazione sottocongiuntivale. La ricerca parassitologia nel sangue e l’isolamento della filaria adulta in entrambi i casi ci ha permesso di porre diagnosi certa di filariasi LoaLoa e di eseguire il trattamento specifico con dietilcarbamazina (Notézine®) In seguito all’osservazione di questi due casi abbiamo eseguito un richiamo clinico, epidemiologico e terapeutico di questa rara affezione nei paesi non endemici. La localizzazione palpebrale per uno specialista poco esperto potrebbe essere causa di confusione diagnostica con altre patologie che realizzano gli stessi quadri patologici

Ocular Alterations in a Rare Case of Segmental Neurofibromatosis Type 1 with a Non-Classified Mutational Variant of the NF-1 Gene

BACKGROUND: Neurofibromatosis type 1 (NF-1) is an autsomal dominant disorder which can occasionally result from somatic mosaicism and manifest as segmental forms of the disease. METHODS: A 37-year-old woman with ascertained NF-1, based on clinical diagnostic criteria and genetic analysis, was referred for ophthalmological evaluation. Genetic analysis, magnetic resonance imaging (MRI), complete ophthalmological examination, and near infrared reflectance (NIR) images at 815 nm of the retina were obtained. RESULTS: Genetic analysis revealed a non-classified mutational variant of the NF-1 gene identified as NM_000267.3:c2084T > C (p.Leu695Pro.T). MRI demonstrated non-symptomatic bilateral optic nerve gliomas. The only cutaneous sign was a subcutaneous neurofibroma of the posterior cervical region. Slit-lamp examination showed bilateral Lisch nodules. NIR images of the retina did not show any choroidal hamartomas. DISCUSSION: We report a rare case of segmental neurofibromatosis with a non-classified mutational variant of the NF-1 gene described in only one previous case in the literature. The patient presented with clinical features of NF-1 localized to the head and neck region, compatible with diagnosis of segmental NF-1. Interestingly, ocular manifestations included bilateral optic nerve gliomas and Lisch nodules, but no choroidal hamartomas. KEYWORDS: Lisch nodules; mosaicism; neurofibromatosis type 1 gene; segmental neurofibromatosi

Spectral domain optical coherence tomography and B-scan ultrasonography in the evaluation of retinal tears in acute, incomplete posterior vitreous detachment

BACKGROUND: The purpose of this study was to evaluate the extension and traction effects of posterior vitreous detachment (PVD) complicated with retinal tears using spectral domain optical coherence tomography (OCT) and B-scan ultrasonography. METHODS: Complete ophthalmological examination, B-scan ultrasonography and spectral domain OCT were performed in patients with acute PVD and retinal tears. Vitreous detachment was classified as complete or incomplete, based on extent of posterior pole or peripheral vitreous detachment. Retinal tear location and persistent traction on the retinal flap was evaluated with B-scan ultrasonography and OCT. Categorical data were evaluated with Fisher's exact test. Statistical significance was considered as P < 0.05. RESULTS: Twenty-six eyes of 25 patients were assessed. Four eyes (15 %) presented complete PVD with detachment at the posterior pole and periphery. 22 eyes (85 %) presented incomplete PVD with detachment in the periphery. Twenty eyes presented retinal tears in the superior quadrants with respect to only 6 in the inferior quadrants (p = 0.006). There was a higher incidence of retinal tears in the pre with respect to post-equatorial areas (19 vs 7 eyes, p = 0.019). B-scan ultrasonography and OCT revealed persistent traction on the retinal tear flap in 19 and 15 eyes, respectively. CONCLUSIONS: In acute PVD, retinal tears are prevalently associated with peripheral vitreous detachment. The impact of complete or incomplete PVD can be of clinical value when evaluating patients with retinal tears

The role of contact lenses and ocular TRAUMA in determining Acanthamoeba Keratitis: a case-control study in Italy.

&lt;p&gt;&lt;strong&gt;Abstract: &lt;/strong&gt;&lt;br /&gt;&lt;strong&gt;Background: &lt;/strong&gt;acanthamoeba keratitis (a.k.) is a rare secondary infection due to acanthamoeba (a) invading the cornea. cofactors of risk may include TrauMa and contact lenses (cL). The objectives of this observational study are to evaluate the occurrence of a.k. in patients accessing the department of Special Senses of the Teaching Hospital “Policlinico umberto I" of rome with ocular infections dur- ing the period from 2005 to 2011, and the role played by risk factors which included contact lenses, TrauMa, sex and age.&lt;br /&gt;&lt;strong&gt;Methods&lt;/strong&gt;: a case-control study involving 714 subjects was conducted (350 male and 364 female). all of the patients underwent a thorough ocular examination with confocal microscopy and a review of their medical history to outline relevant variables (contact lens and TrauMa). Statistical analysis calculated the frequency distribution and the odds ratio (or) (95%cI) for the risk factors "contact lenses" (cL) and "TrauMa". The odds ratio (95%cI) was adjusted for age and sex trough Logistic regression. &lt;strong&gt;Results&lt;/strong&gt;: out of 714 patients, 11 patients (7 male and 4 female) with a mean age of 34.09 years (19 to 51 years old) were found to be affected by a.k. The age group most afflicted ranged from 30 to 51 years old. Statistical analysis produced a crude or equal to 17.68 (95%cI 2.25-138.89) for cL-a.k. and or equal to 7.71 (95%cI 0.89-66.75) for ocular TrauMa.-a.k. Logistic regression performed to adjust or for age and sex showed the following values, respectively: or*=82.54 (95%cI 3.04-2239.58) and or*=11.52 (95%cI 1.19-111.76).&lt;br /&gt;&lt;strong&gt;Conclusions&lt;/strong&gt;: the data highlights an increase in a.k. cases during the 6 year study period. The association between this pathology and the use of contact lenses and/or TrauMa has been statisti- cally proven. The strength of this association increases when the odds ratio (or*) is adjusted for the confounding risk factors of age and sex. When dealing with the topic of acanthamoeba keratitis, it is important to remember that educating patients on proper hygiene practice for contact lenses is the first step towards preventing A.K. The results obtained are important because they are derived from the first Italian case-control study on A.K.&lt;/p&gt

Evaluation of retinal ganglion cell layer in patients with macular edema treated with intravitreal anti-VEFG and corticosteroid

Purpose: The aim of the study is to detect the effect of the different intravitreal therapies (anti-VEFG drugs and corticosteroids) on the single layer of retinal ganglion cells (GCL) in patients affected by macular edema. Methods: Forty (17 males/23 females) Caucasian patients (40 eyes) affected by macular edema treated with intravitreal injections (anti-VEGF and steroids) are included. Spectralis HRA-OCT device with a specific protocol for the acquisition and evaluation of the GCL layer has been used. Macular GCL thickness is assessed with automated retinal segmentation based on ETDRS grid rings. Retinal layer automated segmentation is carefully assessed and manually corrected for any misalignment. GCL measurements are correlated with best-corrected visual acuity (BCVA) measured with Early Treatment Diabetic Retinopathy Study (ETDRS), central macular thickness (CMT) and intraocular pressure (IOP). All patients have been evaluated at baseline and at the subsequent follow-up: 4 weeks, 8 weeks and 12 weeks. Results: Neither anti-VEFG drugs (Bevacizumab, Ranibizumab and Aflibercept) nor corticosteroids (Dexametasone) has a significant effect on GCL layers during three months of follow up compared to long-term treatments. A significant correlation between GCL and ETDRS has found (p=0.0453, R2=0.023). Conclusions: This study shows that anti-VEFG drugs and corticosteroids do not significantly affect GCL layer over three months of treatment. This study also demonstrates that the ganglion cell layer is correlated to visual acuity, an important factor for future investigations on the effects of new treatments

Hiatos de regeneración del bosque de Araucaria araucana en Patagonia: vinculaciones al uso de tierras y desertificación regional

Los bosques de Araucaria araucana (pehuén) son influenciados en su dinámica de regeneración por elementos naturales o antrópicos. Cambios climáticos recientes contribuirían a declinaciones del crecimiento y probablemente en la intensidad de regeneración. Sin embargo, aún luego de extraer madera, vastas extensiones con fisonomía de parque resultaron de fuegos combinado con sobrecarga de ganado introducido desde fines del siglo XIX. Este ganado, condicionado a reducidos corredores de trashumancia y áreas de pastaje, impacta sobre la regeneración del bosque de pehuén en el noroeste de Patagonia argentina. El ganado trashumante, desplazándose desde campos bajos y áridos de invernada a los más húmedos y de mayor receptividad durante el verano en valles cordilleranos, consume retoños y plantas recién germinadas de pehuén, mientras que regresando a campos de invernada consumen la semilla. Como consecuencia, sectores de bosque de pehuén se encuentran escasamente representados respecto de clases etarias menores a 100 años. En este trabajo revisamos los antecedentes relativos a esta ruptura en la estructura etaria que conduce al envejecimiento de las poblaciones de pehuén. Los factores de disturbio mencionados en sociedad con la sobrecarga animal, se revelan como importantes factores de desertificación en territorios del noroeste patagónico.The forests of Araucaria araucana (pehuén) are influenced in their regeneration dynamics by both anthropogenic and natural elements. Recent climatic change contributes to declines in radial growth and likely in the intensity of forest regeneration. However, even when there is past evidences of timber harvesting, vast forest areas with a park physiognomy are consequence of fire influence combined with livestock overstockings that were introduced since the late nineteenth century. These cattle stocks, conditioned to reduced transhumance corridors and limited pasture areas, have produced impacts on plant recruitment at the more xeric pehuén forest patches in the northwestern argentinean Patagonia. The nomad cattle, moving during the beginning of each summer to fields with better livestock receptivity in the mountain valleys, consume the newly germinated pehuén seedlings and when the animals return to winter lowland fields of pastures, they consume the seeds fell during autumn. As a result, many sectors of the pehuén forest are underrepresented regarding age classes lower than 100 years. We review those elements that may be related to the age structure characteristics of the pehuén forests in areas with incidence of human activity. Natural disturbance factors in partnership with overgrazing, are revealed as contributing factors of desertification in the Patagonian northwest territories.Fil: Roig Junent, Fidel Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; Argentina. Universidad Nacional de Cuyo. Facultad de Ciencias Agrarias; ArgentinaFil: Hadad, Martín Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan. Centro de Investigaciones de la Geosfera y Biosfera. Universidad Nacional de San Juan. Facultad de Ciencias Exactas Físicas y Naturales. Centro de Investigaciones de la Geosfera y Biosfera; ArgentinaFil: Moreno, Angela Carolina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Patagonia Norte. Estación Experimental Agropecuaria San Carlos de Bariloche; ArgentinaFil: Gandullo, Ricardo J.. Universidad Nacional del Comahue. Facultad de Ciencias Agrarias; ArgentinaFil: Piraino, Sergio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Martinez Carretero, Eduardo Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Gonzalez Loyarte, Maria Margarita. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Arco Molina, Julieta Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Bendini, Monica Isabel. Universidad Nacional del Comahue. Facultad de Derecho y Cs.sociales. Grupo de Estudios Sociales Agrarios; ArgentinaFil: Boninsegna, Jose Armando. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Peralta, Iris Edith. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; Argentina. Universidad Nacional de Cuyo. Facultad de Ciencias Agrarias; ArgentinaFil: Barrio, Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Bottero, Rafael. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Patón Domínguez, Daniel. Departamento de Biología Vegetal, Ecología y Ciencias de la Tierra. Universidad de Extremadura; EspañaFil: Juaneda, Emilio. Ministerio de Agricultura, Ganaderia, Pesca y Alimento; ArgentinaFil: Trevizor, Tassio. Universidade de Sao Paulo; Brasil. University of Sao Paulo. Department of Forest Sciences. Wood anatomy & Tree-Ring Laboratory; BrasilFil: Duplancic Videla, María Andrea del Carmen. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; Argentin

Clinical findings after bioresorbable vascular scaffold implantation in an unrestricted cohort of patients with ST-segment elevation myocardial infarction (from the RAI registry)

BACKGROUND: The bioresorbable vascular scaffold (BVS) technology may be an appealing option in ST-segment elevation myocardial infarction (STEMI) patients. However, the available evidence on its use in this challenging subset is limited. METHODS: Registro Absorb Italiano (RAI) is a multicenter, prospective registry that aims to assess BVS performance through a 5-year follow-up of all consecutive patients who undergone at least 1 successful BVS implantation. As a part of it, a subgroup analysis in STEMI patients was performed and the outcomes of this cohort compared to the remaining population (defined as "non-STEMI") are reported here. RESULTS: Among the 1505 patients enrolled, 317 (21.1%) had STEMI on admission. Among those, 232 (73.2%) underwent primary percutaneous coronary intervention (PCI) within 12\u202fh from symptom onset; 64 (20.2%) were late-comers (>12\u202fh); 16 (5%) underwent PCI after successful thrombolysis while 5 (1.6%) underwent rescue-PCI. At a median follow-up time of 12\u202fmonths (IQR 6-20\u202fmonths) no differences were noticed between STEMI and "non-STEMI" groups in terms of device-oriented composite endpoint (4.1% vs. 5.6%; p\u202f=\u202f0.3) and its singular components: ischemia-driven target lesion revascularization (3.2% vs. 3.6%; p\u202f=\u202f0.7), target-vessel myocardial infarction (3.2% vs. 2.8%; p\u202f=\u202f0.7) and cardiac death (0.6% vs. 0.6%; p\u202f=\u202f0.9). The rate of definite/probable scaffold thrombosis (ScT) was numerically higher but not significant in the STEMI group (2.5% vs. 1.3%; p\u202f=\u202f0.1). CONCLUSIONS: BVS implantation in an unrestricted cohort of STEMI patients is associated with a numerically higher rate of ScT compared to the non-STEMI group. Further studies exploring the potential clinical impact of a pre-specified BVS implantation strategy in this high-risk clinical setting are needed